0366 Sleep Health Dimensions, Disturbances, and Disruptors Among White, Black, Hispanic/ Latina, and Asian Women

Abstract Introduction Despite the importance of sleep for health promotion and disease prevention, data are limited regarding the distribution of multiple sleep health dimensions, disturbances, and disruptors among women, especially racial/ethnic minorities who disproportionately experience poor sleep. Methods To determine the prevalence of sleep health, disturbances, and disruptors (e.g., short sleep duration, sleep debt, insomnia symptoms, light exposure at night) overall and among Black, Hispanic/Latina, and Asian compared to White women, we used cross-sectional data collected by the Sister Study at enrollment (2003-2009) and two follow-ups (2012-2014, 2014-2016). Adjusting for sociodemographics, health behaviors, and health conditions including depression, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) for unfavorable sleep among racial/ethnic minority compared to White women. Results Of the 49,874 eligible women (mean age ± standard deviation: 55.7 ± 9.0 years, 84.8% ≥high school education, 74.7% married) 85.3% were White, 9.0% Black, 5.1% Hispanic/Latina, and 0.7% Asian. Overall, 70% reported the recommended amount of sleep, 15.7% inconsistent weekly sleep patterns, 26% sleep debt, and 14% insomnia symptoms plus short sleep. Racial/ethnic minorities were much more likely than whites to report very short (≤5 hours) sleep (PRBlack)=5.98[95% Confidence Interval: 4.67-7.66]; PRLatina=2.83[1.98-4.04]; PRAsian=5.41[2.41-12.13] and to report needing <7 hours to feel their best (PRBlack=2.95[2.75-3.17]; PRLatina=1.85[1.65-2.07]; PRAsian=2.66[2.10-3.37]). Black and Hispanic/Latina women had a higher prevalence than whites of insomnia, short sleep plus insomnia, inconsistent sleep, sleep debt, and frequent napping; however, all racial/ethnic minorities were less likely to report daytime sleepiness (PRBlack=0.82[0.78-0.85]; PRLatina=0.94[0.89-0.98]; PRAsian=0.79[0.69-0.92]) and restless leg syndrome. Witnessed sleep apnea was higher among Black women, and REM sleep disorder did not differ across racial/ethnic groups. Sleeping with room lights or a television on was more prevalent among racial/ethnic minorities (PRBlack=1.78[1.71-1.86]; PRLatina=1.27[1.17-1.37]; PRAsian=1.62[1.32-1.99]). Conclusion Poor sleep health, disturbances, and disruptors were prevalent among women and varied across racial/ethnic groups in ways that may contribute to health disparities. Support This work was funded by the Intramural Program at the National Institutes of Health, National Institute of Environmental Health Sciences (Z1A ES103325-01 to (CLJ) and Z01 ES044005 to (DPS)).

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318 Area Deprivation and Sleep Health among White, Black, and Hispanic/Latina Women

SLEEP ◽

10.1093/sleep/zsab072.317 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A127-A128

Author(s):

Symielle Gaston ◽

Kaitlyn Lawrence ◽

Dale Sandler ◽

Chandra Jackson

Keyword(s):

White Women ◽

Deprivation Level ◽

Area Deprivation ◽

Poor Sleep ◽

Latina Women ◽

Sleep Health ◽

Neighborhood Deprivation ◽

Sleep Debt ◽

Race Ethnicity ◽

Insomnia Symptoms

Abstract Introduction Although neighborhood environments have been shown to affect sleep health, few studies have directly measured multiple indicators of both neighborhood deprivation and sleep while considering modification by race/ethnicity. Methods Among 49,833 eligible U.S. women enrolled in the Sister Study from 2003 to 2009, we investigated associations between neighborhood deprivation (e.g., percentage of residents unemployed, household crowding) and multiple sleep dimensions. Participants’ addresses were linked to U.S. census block group level Area Deprivation Index rankings (range: 1–100) for the year 2000, and participant rankings were divided into quintiles where the highest quintile represented the highest deprivation level. Participants self-reported habitual sleep duration, sleep debt, frequent napping, and insomnia symptoms. Adjusting for sociodemographic and clinical characteristics, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for sleep dimensions among participants within quintiles (Qs) 2–5 vs. Q1. Interaction terms were used to assess modification by race/ethnicity. Results Mean age ± standard deviation was 55 ± 9 years. Women with higher neighborhood deprivation were more likely to self-identify as a racial/ethnic minority and had higher unadjusted prevalence of poor sleep dimensions. After adjustment, higher ADI was positively associated with very short sleep (≤5 hours), and race/ethnicity was a modifier (e.g., race-stratified results for Q5 vs. Q1:PRWhite=1.31 [95% CI: 1.14–1.51], PRBlack=0.91 [0.71–1.18], PRHispanic/Latina= 1.17 [0.68–2.04], p-interaction <0.05). Although race/ethnicity did not modify remaining associations, women with higher neighborhood deprivation also had a higher prevalence of sleep debt, frequent napping, and insomnia symptoms. When compared to White women with the lowest neighborhood deprivation, Black women across all deprivation levels and Hispanic/Latina women in Q2-Q5 were substantially more likely to report each poor sleep dimension (PR range: 1.21 to 5.01). Conclusion A multidimensional measure of neighborhood deprivation was associated with poor sleep and sleep disparities among a diverse cohort of U.S. women. Support (if any):

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Racial/Ethnic Disparities in Mammogram Frequency Among Women With Intellectual Disability

Intellectual and Developmental Disabilities ◽

10.1352/1934-9556-57.3.177 ◽

2019 ◽

Vol 57 (3) ◽

pp. 177-187 ◽

Cited By ~ 1

Author(s):

Evelyn Arana ◽

Amy Carroll-Scott ◽

Philip M. Massey ◽

Nora L. Lee ◽

Ann C. Klassen ◽

...

Keyword(s):

Intellectual Disability ◽

Black Women ◽

Medical Record ◽

Ethnic Groups ◽

White Women ◽

Ethnic Disparities ◽

Medical Record Data ◽

Record Data ◽

Race Ethnicity ◽

Racial Ethnic

Abstract Little information exists on the associations between intellectual disability (ID) and race/ethnicity on mammogram frequency. This study collected survey and medical record data to examine this relationship. Results indicated that Hispanic and Black women with ID were more likely than White women with ID to have mammograms every 2 years. Participants who live in a state-funded residence, were aged 50+, and had a mild or moderate level of ID impairment were more likely to undergo mammography compared to participants living with family or alone, were <50, and had severe ID impairment. Further research is needed to understand the mechanisms explaining disparities in mammograms between these racial/ethnic groups.

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0919 Health Disparities in the Persistence of Childhood Insomnia Symptoms in the Transition to Adolescence: The Penn State Child Cohort

SLEEP ◽

10.1093/sleep/zsaa056.915 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A349-A349

Author(s):

E Bourchtein ◽

K Puzino ◽

S L Calhoun ◽

C Criley ◽

F He ◽

...

Keyword(s):

Socioeconomic Status ◽

Ethnic Minorities ◽

Remission Rate ◽

Self Report ◽

Full Remission ◽

Penn State ◽

State Child ◽

Racial Ethnic ◽

Insomnia Symptoms

Abstract Introduction A strong body of cross-sectional evidence indicates that social determinants of health (SDH), such as race, ethnicity, socioeconomic status, and sex/gender, are linked to sleep problems, including insomnia symptoms. Few studies have examined the longitudinal association between SDH and the persistence and remission of insomnia symptoms in the transition between childhood and adolescence, a critical period for sleep health. Methods The Penn State Child Cohort is a random, population-based sample of 700 children (5-12y at baseline), of whom 421 were followed up as adolescents (12-23y at follow-up). All subjects underwent polysomnography, clinical history, physical exam, and parent- and self-reported scales at baseline and follow-up. Childhood insomnia symptoms were defined as a parent- and/or self-report of difficulty falling and/or staying asleep. All subjects or their parents identified the subject’s sex, race, and ethnicity, and reported on socioeconomic status (SES) of the household. Results Females (32.7%) and racial/ethnic minorities (25.0%) were associated with a significantly lower remission rate as compared to males (53.3%) and non-Hispanic whites (48.3%), respectively. Non-Hispanic whites of low SES were associated with a significantly lower full remission rate (26.3%) as compared to non-Hispanic whites of higher SES (42.0%), while racial/ethnic minorities were associated with the lowest full remission rates regardless of whether they were of low (9.1%) or higher (11.1%) SES. Conclusion Our novel data indicate that gender-, racial/ethnic- and socioeconomic-related disparities in insomnia not only occur as early as childhood but are important determinants of insomnia’s chronic course throughout development. Support National Institutes of Health (R01HL136587, R01HL97165, R01HL63772, UL1TR000127)

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Various Types of Perceived Job Discrimination and Sleep Health Among Working Women: Findings From the Sister Study

American Journal of Epidemiology ◽

10.1093/aje/kwaa075 ◽

2020 ◽

Vol 189 (10) ◽

pp. 1143-1153 ◽

Cited By ~ 1

Author(s):

Soomi Lee ◽

Anne-Marie Chang ◽

Orfeu M Buxton ◽

Chandra L Jackson

Keyword(s):

Health Disparities ◽

Confidence Interval ◽

Odds Ratio ◽

Sleep Problems ◽

Working Women ◽

Sleep Health ◽

Short Sleep ◽

Job Discrimination ◽

Insomnia Symptoms ◽

New Onset

Abstract Job discrimination, a social stressor, may lead to sleep health disparities among workers; yet, limited research has examined this relationship and specific sources of job discrimination. We used a US sample of working women (n = 26,085), participants in the Sister Study (2008–2016), to examine the associations of perceived job discrimination due to sex, race, age, health conditions, and/or sexual orientation with sleep health. Cross-sectionally, linear or logistic regression models revealed that each source of job discrimination was independently associated with different sleep problems after controlling for other sources of job discrimination. Longitudinally, among participants without short sleep (<7 hours/night) at time 1 (2012–2014), age-specific job discrimination was associated with 21% increased odds of new-onset short sleep (odds ratio = 1.21, 95% confidence interval: 1.03, 1.43) at time 2 (2014–2016). Among those without insomnia symptoms at time 1, race-specific job discrimination was associated with 37% increased odds of new-onset insomnia symptoms (odds ratio = 1.37, 95% confidence interval: 1.07, 1.75) at time 2. Sex- and health-specific job discrimination also predicted new-onset sleepiness. There were dose-response relationships such that a greater number of sources of job discrimination (≥3) was associated with greater odds of prevalent and incident sleep problems. Perceived job discrimination may contribute to working women’s poor sleep health over time, raising concerns about sleep health disparities emanating from the workplace.

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Exploring Inconsistent Counts of Racial/Ethnic Minorities in a 2010 Census Ethnographic Evaluation

Bulletin of Sociological Methodology/Bulletin de Méthodologie Sociologique ◽

10.1177/0759106317710849 ◽

2017 ◽

Vol 135 (1) ◽

pp. 32-49 ◽

Cited By ~ 1

Author(s):

Rodney L. Terry ◽

Laurie Schwede ◽

Ryan King ◽

Mandi Martinez ◽

Jennifer Hunter Childs

Keyword(s):

United States ◽

Ethnic Groups ◽

Ethnic Minorities ◽

Race And Ethnicity ◽

Cultural Awareness ◽

Data Sources ◽

Cultural Issues ◽

Factors Affecting ◽

Racial Ethnic ◽

Differential Counts

Previous research has shown differential counts by race and ethnicity across several recent United States decennial censuses. This article presents findings from a 2010 Census ethnographic evaluation with a record check, conducted to identify factors affecting enumeration among racial/ethnic groups. In eight sites targeted to major racial/ethnic groups, ethnographers observed live census interviews and assessed where persons should have been counted. In the record check, housing unit rosters were matched with four data sources to identify inconsistencies in where to count persons. Ethnographic themes that contributed to record check inconsistencies include respondent access difficulty, language issues, and cultural issues. Ways to improve enumeration include improving access to hard-to-reach respondents and increasing the cultural awareness of enumerators.

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Trastuzumab-induced cardiotoxicity and hypertension among racially and ethnically diverse patients with HER2-positive early-stage breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2020.38.15_suppl.e24092 ◽

2020 ◽

Vol 38 (15_suppl) ◽

pp. e24092-e24092

Author(s):

Monica F. Chen ◽

Daniel K. Manson ◽

Ariel Yuan ◽

Katherine D. Crew

Keyword(s):

Breast Cancer ◽

Ethnic Groups ◽

Ethnic Minorities ◽

Early Stage ◽

Early Stage Breast Cancer ◽

Her2 Positive ◽

Factors Associated ◽

Race Ethnicity ◽

Racial Ethnic ◽

Hispanic White

e24092 Background: Trastuzumab improves breast cancer survival but is associated with an increased risk of heart failure. Identifying risk factors associated with trastuzumab induced cardiotoxicity (TIC) would allow for more targeted and intensive screening for at-risk patients. Hypertension is one of the most consistent predictors of TIC. Racial/ethnic minorities are at higher risk of cardiovascular disease but are under-represented in studies of TIC. The objective of this study was to evaluate the relationship between race/ethnicity and risk of TIC among a diverse cohort of patients with HER2-positive early-stage breast cancer. Methods: We conducted a retrospective cohort study of patients treated at Columbia University between 2007 and 2016 for stage I-III breast cancer with adjuvant or neoadjuvant trastuzumab who had at least two echocardiograms. Mild TIC was defined as a ≥10% decline in left ventricular ejection fraction (LVEF); moderate TIC ≥15% decline; severe TIC ≥20% or decline in LVEF to < 50%. Diagnosis of hypertension, average systolic and diastolic blood pressure, and number of hypertension medications was assessed 1- year pre-treatment, during treatment, and 1-year post-treatment. We generated descriptive statistics and used multivariable logistic regression to evaluate demographic and clinical factors associated with TIC. Results: Of 279 patients evaluated, 36.6% were non-Hispanic white, 18.3% non-Hispanic black, 34.8% Hispanic, and 10.4% Asian. The average baseline LVEF was 60% and did not significantly differ between racial/ethnic groups. Mild TIC developed in 33.3% of patients, moderate TIC 18.6%, severe TIC 15.8%, and 14.7% with LVEF decline to < 50%. Patients with hypertension were at increased odds of developing TIC (OR = 2.41, 95% CI = 1.15-3.93; p = 0.02). Prevalence of hypertension was 53% among non-Hispanic white women, 69% non-Hispanic black, 53% Hispanic, and 39% Asian. Incidence of TIC did not differ significantly between racial/ethnic groups. Forty percent of patients with hypertension were not on any medications before initiating trastuzumab. Conclusions: There was no difference in TIC based upon race/ethnicity despite higher rates of hypertension among racial/ethnic minorities compared to non-Hispanic whites. However, a high portion of patients with hypertension were not on any medications before treatment. Increased screening and treatment of hypertension among patients receiving HER2-positive targeted therapy for early-stage breast cancer may be warranted.

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Multiple sleep dimensions and type 2 diabetes risk among women in the Sister Study: differences by race/ethnicity

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2019-000652 ◽

2019 ◽

Vol 7 (1) ◽

pp. e000652 ◽

Cited By ~ 1

Author(s):

Ketrell L McWhorter ◽

Yong-Moon Park ◽

Symielle A Gaston ◽

Kacey B Fang ◽

Dale P Sandler ◽

...

Keyword(s):

Type 2 Diabetes ◽

Ethnic Minorities ◽

Sleep Latency ◽

Diabetes Risk ◽

Poor Sleep ◽

Increased Risk ◽

Race Ethnicity ◽

Racial Ethnic

ObjectivePoor sleep has been associated with type 2 diabetes. Since racial/ethnic minorities experience a disproportionately high prevalence of poor sleep and type 2 diabetes, we sought to determine the relationships between multiple sleep dimensions and incident type 2 diabetes and to investigate if these relationships vary by race/ethnicity.Research design and methodsProspective data were analyzed from the Sister Study, which enrolled 50 884 women from 2003 to 2009. Participants self-reported sleep duration, sleep latency, night awakenings, and napping at baseline, and a physician’s diagnosis of type 2 diabetes at follow-up. Multivariable-adjusted HRs and 95% CIs were estimated using Cox proportional hazards models.ResultsAmong the 39 071 eligible participants, 87% self-identified as white, 8% black and 5% Hispanic/Latina. The mean follow-up period was 8.5±2.1 years and 1785 type 2 diabetes cases were reported. The incidence rate per 1000 person-years was 5.4 for whites, 13.3 for blacks and 11.6 for Hispanics/Latinas. There was a positive but non-significant increased risk of type 2 diabetes among women who reported short sleep, latency >30 min and frequent night awakenings. In fully-adjusted models, frequent napping was associated with a 19% (HR 1.19, 95% CI 1.04 to 1.37) higher type 2 diabetes risk in the overall sample. Poor sleep among racial/ethnic minorities ranged from a 1.4-fold to a 3.2-fold higher type 2 diabetes risk than whites with recommended sleep.ConclusionsFrequent napping was associated with higher type 2 diabetes risk. Racial/ethnic minorities with poor sleep had a higher type 2 diabetes risk than whites with recommended sleep.

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Racial/ethnic variation in trauma-related psychopathology in the United States: a population-based study

Psychological Medicine ◽

10.1017/s0033291718003082 ◽

2018 ◽

Vol 49 (13) ◽

pp. 2215-2226 ◽

Cited By ~ 8

Author(s):

Katie A. McLaughlin ◽

Kiara Alvarez ◽

Mirko Fillbrunn ◽

Jennifer Greif Green ◽

James S. Jackson ◽

...

Keyword(s):

Mental Disorders ◽

Ethnic Groups ◽

Ethnic Minorities ◽

Ethnic Differences ◽

Physical Violence ◽

The United States ◽

National Sample ◽

Post Traumatic Stress ◽

Organized Violence ◽

Racial Ethnic

AbstractBackgroundThe prevalence of mental disorders among Black, Latino, and Asian adults is lower than among Whites. Factors that explain these differences are largely unknown. We examined whether racial/ethnic differences in exposure to traumatic events (TEs) or vulnerability to trauma-related psychopathology explained the lower rates of psychopathology among racial/ethnic minorities.MethodsWe estimated the prevalence of TE exposure and associations with onset of DSM-IV depression, anxiety and substance disorders and with lifetime post-traumatic stress disorder (PTSD) in the Collaborative Psychiatric Epidemiology Surveys, a national sample (N = 13 775) with substantial proportions of Black (35.9%), Latino (18.9%), and Asian Americans (14.9%).ResultsTE exposure varied across racial/ethnic groups. Asians were most likely to experience organized violence – particularly being a refugee – but had the lowest exposure to all other TEs. Blacks had the greatest exposure to participation in organized violence, sexual violence, and other TEs, Latinos had the highest exposure to physical violence, and Whites were most likely to experience accidents/injuries. Racial/ethnic minorities had lower odds ratios of depression, anxiety, and substance disorder onset relative to Whites. Neither variation in TE exposure nor vulnerability to psychopathology following TEs across racial/ethnic groups explained these differences. Vulnerability to PTSD did vary across groups, however, such that Asians were less likely and Blacks more likely to develop PTSD following TEs than Whites.ConclusionsLower prevalence of mental disorders among racial/ethnic minorities does not appear to reflect reduced vulnerability to TEs, with the exception of PTSD among Asians. This highlights the importance of investigating other potential mechanisms underlying racial/ethnic differences in psychopathology.

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0756 SHORT SLEEP DURATION DRIVES ACCELERATED AGING IN THE UNITED STATES ESPECIALLY AMONG RACIAL/ETHNIC MINORITIES

SLEEP ◽

10.1093/sleepj/zsx050.755 ◽

2017 ◽

Vol 40 (suppl_1) ◽

pp. A280-A280

Author(s):

A Seixas ◽

R Kanchi ◽

A Langford ◽

A Rogers ◽

S Williams ◽

...

Keyword(s):

United States ◽

Ethnic Minorities ◽

Sleep Duration ◽

Accelerated Aging ◽

The United States ◽

Short Sleep Duration ◽

Short Sleep ◽

Racial Ethnic

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Anxiety and depressive symptoms are associated with poor sleep health during a period of COVID-19-induced nationwide lockdown: a cross-sectional analysis of adults in Jordan

BMJ Open ◽

10.1136/bmjopen-2020-041995 ◽

2020 ◽

Vol 10 (12) ◽

pp. e041995

Author(s):

Yazan A Al-Ajlouni ◽

Su Hyun Park ◽

Jude Alawa ◽

Ghaith Shamaileh ◽

Aziz Bawab ◽

...

Keyword(s):

Depressive Symptoms ◽

Sleep Quality ◽

Health Outcomes ◽

Sleep Duration ◽

Sleep Problem ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Short Sleep Duration ◽

Sleep Health ◽

Short Sleep

Background Jordan, a Middle Eastern country, declared a state of national emergency due to COVID-19 and a strict nationwide lockdown on 17 March 2020, banning all travel and movement around the country, potentially impacting mental health. This study sought to investigate the association between mental health (eg, anxiety and depressive symptoms) and sleep health among a sample of Jordanians living through a state of COVID-19-induced nationwide lockdown. Methods Using Facebook, participants (n=1240) in Jordan in March 2020 were recruited and direct to a web-based survey measuring anxiety (items from General Anxiety Disorder 7-item (GAD-7) scale instrument), depressive symptoms (items from Center for Epidemiologic Studies Depression Scale), sleep health (items from the Pittsburgh Sleep Quality Index) and sociodemographic. A modified Poisson regression model with robust error variance. Adjusted prevalence ratios (aPRs) and 95% CIs were estimated to examine how anxiety and depressive symptoms may affect different dimensions of sleep health: (1) poor sleep quality, (2) short sleep duration, (3) encountering sleep problems. Results The majority of participants reported having experienced mild (33.8%), moderate (12.9%) or severe (6.3%) levels of anxiety during lockdown, and nearly half of respondents reported depressive symptoms during lockdown. Similarly, over 60% of participants reported having experienced at least one sleep problem in the last week, and nearly half reported having had short sleep duration. Importantly, anxiety was associated with poor sleep health outcomes. For example, corresponding to the dose–response relationship between anxiety and sleep health outcomes, those reporting severe anxiety were the most likely to experience poor sleep quality (aPR =8.95; 95% CI=6.12 to 13.08), short sleep duration (aPR =2.23; 95% CI=1.91 to 2.61) and at least one problem sleep problem (aPR=1.73; 95% CI=1.54 to 1.95). Moreover, depressive symptoms were also associated with poor sleep health outcomes. As compared with scoring in the first quartile, scoring fourth quartile was associated with poor sleep quality (aPR=11.82; 95% CI=6.64 to 21.04), short sleep duration (aPR=1.87; 95% CI=1.58 to 2.22), and experiencing at least one sleep problem (aPR=1.90; 95% CI=1.66 to 2.18). Conclusions Increased levels of anxiety and depressive symptoms can negatively influence sleep health among a sample of Jordanian adults living in a state of COVID-19-induced nationwide lockdown.

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