Abstract P469: Ambient Weather is Associated With Sleep and Activity in Rural South
Authors: Tejan Joseph J , Barnett Ian , DeGaetano Arthur , Wang Ziyue , Kheterpal Vik , Schramm Eric , Raval Shivani , Weaver Gretchen , Montenario Matheus , Agyapong Nakesha , DeGaetano Amy , Tisminetzky Mayra , Mujahid Mahasin S , Judd Suzanne E , Ramachandran Vasan S , McManus David D , Soni Apurv 
Published: May 2024

Background:
Physical activity and sleep are two of the Life’s Essential 8 steps for a healthy lifestyle and prevention of cardiovascular disease. The role of weather on an individual’s ability to meet physical activity and sleep goals is unknown. This is relevant in rural settings where the risk of cardiovascular disease is disproportionately high and extreme weather patterns are common.

Objective:
To investigate the association between local weather conditions and physical activity and sleep, as measured by Fitbit devices among participants in rural Alabama.

Methods:
Participants were enrolled from rural counties in Alabama as part of an observational study to understand cardiovascular risk in the rural Southeast. Each enrolled participant was given a Fitbit device to collect physical activity and sleep data, including total steps per day and sleep duration for six months. Weather data were obtained from a NOAA Regional Climate Center’s Applied Climate Information System for the dates each participant collected physical activity and sleep data using the participants’ zip code as location. A linear mixed effects model was used to examine the associations of daily precipitation, minimum and maximum daily ambient temperature (modeled as tertiles), BMI, gender, and age with sleep duration and daily physical activity.

Results:
A total of 942 participants were enrolled in the subcohort from the Alabama counties and 716 (76%) received a Fitbit device. Complete data were available from 561 participants generating 63,176 study-days. The subcohort average age was 48.8 with average BMI of 36.0 Kg/m
2
, 70% (n =660) female, and 78.7% (n = 751) Black. On average, women slept 29.1 more minutes every night (p< 0.001) but recorded 1,225 fewer steps (p <0.001) in comparison to men. An increase in BMI (1 Kg/m
2
increment) was associated with lesser sleep duration (0.98 minutes; p = 0.02) and lower daily step count (70.5, p <0.001). After adjusting for confounders, the upper tertile of ambient daily maximum temperature was associated with lesser sleep duration (5.3 minutes, p<0.001) and physical activity (218 steps, p < 0.001) in comparison to the middle tertile (referent). Conversely lowest tertile of ambient daily maximum temperature was associated with longer sleep duration (5.7 minutes, p=0.003) but not physical activity (22.0 steps, p = 0.71). An increase of an inch of ambient daily precipitation was not significantly associated with sleep duration (p=.49) but was associated with decreased physical activity (251 steps p <0.001).

Conclusions:
In our cross-sectional study, local temperature and precipitation were associated with lesser sleep duration and physical activity. Further analyses are warranted to understand patterns of these associations and the identification of factors that exacerbate or mitigate these weather-related associations may inform clinical practices and research direction.