0114 “My Mother Doesn't Sleep When It Rains at Night”: Assessing the Impacts of a Climate-Related Flood on Sleep

Abstract Introduction Climate change and climate-sensitive disasters pose a serious threat to sleep health. Populations with pre-existing sleep and health disparities are particularly vulnerable to disaster related stress. In 2022 Eastern Kentucky, home to some of the nation’s largest “hotspots” of insufficient sleep, experienced thunderstorms resulting in 14-16 inches of rain. Subsequent catastrophic flooding and landslides claimed more than 40 lives and left thousands homeless. The present study used mixed methods to investigate the impacts of this flood disaster on the sleep and health of flood survivors. Methods We collected two waves of qualitative and quantitative data from 25 participants (18+) living in five flood-impacted counties in Eastern KY. Data were collected at 9- and 15-months post-flood. Semi-structured qualitative interviews at both waves explored perceived flood impacts on sleep and health. Quantitative surveys assessed sleep, stress, trauma symptoms, and other health outcomes via well-validated scales. Interviews were professionally transcribed and coded using an inductive process and NVIVO software. Insomnia symptoms were assessed using the Insomnia Severity Index (ISI). Results At 9 months post-flood 77% of participants’ ISI scores were ◻15 suggesting clinically significant insomnia. Fifteen months post-flood, 68% of participants reported ISI scores ◻15. Most (72%) participants reported that the flood event and its aftermath directly impacted their sleep. Sixty-one percent reported delays in falling asleep and increased nighttime awakening; 22% woke up too early. Over half (56%) had racing or recurring thoughts related to the flood and 44% had nightmares. In interviews participants specifically linked increased anxiety to their difficulties with sleep. Many said that the sound of rain triggered an inability to fall or stay asleep in themselves or a family member. Changes in sleep environment also disrupted sleep; issues included destroyed or damaged housing, temporary housing, and mold problems. Conclusion Flood survivors in Eastern KY, a region already rife with sleep and health disparities, reported disturbed sleep at 9- and 15-months post flood. The sound of rain and/or changes in sleep environment impacted survivors’ sleep long after the flood event. As climate-sensitive disasters increase, sleep health in vulnerable populations must remain a focus of research and intervention. Support (if any) R01MD016236, UL1TR001998 and ES026529