170 Hispanic Ethnicity May Be Associated with Short Sleep Duration and Elevated Sleep Distress in U.S. Air Force Trainees

Abstract Introduction Sleep research among Hispanic populations is limited. Hispanics may be at higher risk of poor sleep when compared to other race/ethnicities. Non-white and other socioeconomically disadvantaged populations have higher rates of chronic health conditions. Epidemiological studies have substantiated the correlation between short sleep and a variety of negative health outcomes. Sleep is foundational to overall good health and functioning, impacting academic and physical performance in technical training, and crucial for an airmen’s adjustment to the rigor of a military career. Authors explored the role of race/ethnicity on perceived sleep health (e.g., sleep duration and sleep distress) among airmen attending technical school. Methods Sleep health survey was administered to two groups of Airmen at an Air Force technical training: In-processing: Airmen who just arrived to begin technical training, (n=187), Age: M= 20.83 (SD 3.26), 82.55% Male; upon completion of training, i.e., Out-processing: Airmen about to complete technical training, (n=302), Age M = 20.7 (SD 3.09), 85.81% Male. To account for correlations between Airmen from the same squadron, a covariates-adjusted generalized mixed-effects model was used. Associations between race/ethnicity and short sleep duration (≤6 hours), and between race/ethnicity and sleep pattern distress—among shorter sleepers as a sub-group—were examined. Racial/Ethnic frequency among short sleepers (n=135): 19.3 % Hispanic, 13.3% NH-Black, 55.6% NH-White, 6.6% NH-Multiracial, and 5.2% NH-Other. Results Among Hispanic Airmen, the out-processing group was 2.25 times as likely as the in-processing group to be short sleepers on weekdays (95% CI: 1.15 to 4.38, p=0.017). Among short sleepers in the out-processing group, Hispanic Airmen were significantly more worried/distressed about their sleep pattern than Black and White Airmen (OR=2.29, 95% CI: 1.18 to 4.42, p=0.014 and OR=2.29, 95% CI: 1.10 to 4.76, p=0.026, respectively). Conclusion Short sleep duration is a significant problem in the military and results suggest that race/ethnicity-related contextual factors may point to at risk subgroups. Others have considered the influence of perceived prejudice, access to social capital, cultural barriers to academic success, and potential sensitivity to somatic discomfort on sleep complaints. Future directions involve repeating this assessment with another cohort of technical training Airmen to see if findings replicate. Support (if any) none

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Abstract MP073: Sleep Patterns and Depression in a Diverse Sample of Women from the AHA Go Red for Women Strategically Focused Research Network (SFRN)

Circulation ◽

10.1161/circ.135.suppl_1.mp073 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Brooke Aggarwal ◽

Ming Liao

Keyword(s):

Depressive Symptoms ◽

Sleep Quality ◽

Sleep Duration ◽

Minority Women ◽

Poor Sleep ◽

Sleep Patterns ◽

Short Sleep Duration ◽

Short Sleep ◽

Long Sleep ◽

Race Ethnicity

Background: Depression has been linked to increased risk of cardiovascular disease (CVD) through biological mechanisms and altered lifestyle behaviors, possibly including short and/or long sleep duration. However the relation between specific sleep components and depressive symptoms, and interaction by race/ethnicity has not been fully defined. The purpose of this study was to determine if sleep patterns including short sleep duration, poor sleep quality, and insomnia were associated with depressive symptoms in a free-living ethnically diverse population of adult women, and if they varied by racial/ethnic status. Methods: English or Spanish speaking females between the ages of 20-79 y, participating in an observational cohort study as part of the American Heart Association Go Red for Women SFRN, were included (n=50, 56% (28 of 50) non-white, mean age = 41 ±18y). Sleep patterns were assessed using the Pittsburgh Sleep Quality Index (PSQI), a validated instrument used to measure the quality and duration of sleep in adults. Presence of insomnia was measured using the Insomnia Severity Index (ISI). Depressive symptoms were assessed using the Beck Depression Inventory (BDI-II). Linear and logistic regression models were used to evaluate cross-sectional associations between sleep patterns and depression overall, and by race/ethnicity. Results: Overall, nearly one-fifth of participants had depressive symptoms (BDI II score ≤13), 18% (9 of 50) had short sleep duration (<6 hours per night), 38% (19 of 50) had poor quality sleep (PSQI score ≥5), and 40% (20 of 50) had some level of insomnia (ISI score ≥8). Mean BDI-II scores among women who slept <6 versus ≥6 hours were significantly greater (16 versus 5, p=.0003). Higher depression scores were associated with shorter sleep duration (p=.001), poorer sleep quality (p=.03), and higher insomnia severity (p<.0001) overall. There was no association between depression and long sleep (≥8 hours). When stratified by race/ethnicity, depression was significantly associated with poor sleep quality among minority women in multivariable models adjusted for demographic confounders (OR=1.42, 95% CI=1.03-1.95), but not among non-Hispanic white women. Depression was also significantly associated with insomnia severity (p<.001), and sleep duration (p=.03) among minority women only, in multivariable adjusted models stratified by race/ethnicity. Conclusions: In this diverse sample of women, sleep problems were highly prevalent. Poor sleep quality, insomnia, and short sleep duration (but not long sleep) were associated with greater depressive symptoms among minority women but not whites. These preliminary data suggest that minority women with short sleep duration may be at heightened CVD risk from depression. Future research should determine if interventions designed to improve sleep result in decreased depressive symptoms and reduced CVD risk.

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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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Neighborhood Social Cohesion and Sleep Health by Age, Sex/Gender, and Race/Ethnicity in the United States

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17249475 ◽

2020 ◽

Vol 17 (24) ◽

pp. 9475

Author(s):

Dana M. Alhasan ◽

Symielle A. Gaston ◽

W. Braxton Jackson ◽

Patrice C. Williams ◽

Ichiro Kawachi ◽

...

Keyword(s):

Sleep Duration ◽

Social Cohesion ◽

Sleep Disturbances ◽

The United States ◽

Poor Sleep ◽

Short Sleep Duration ◽

Sleep Health ◽

Short Sleep ◽

Neighborhood Social Cohesion ◽

Waking Up

Although low neighborhood social cohesion (nSC) has been linked with poor sleep, studies of racially/ethnically diverse participants using multiple sleep dimensions remain sparse. Using National Health Interview Survey data, we examined overall, age, sex/gender, and racial/ethnic-specific associations between nSC and sleep health among 167,153 adults. Self-reported nSC was categorized into low, medium, and high. Very short sleep duration was defined as <6 hours; short as <7 h, recommended as 7–9 h, and long as ≥9 h. Sleep disturbances were assessed based on trouble falling and staying asleep, waking up feeling unrested, and using sleep medication (all ≥3 days/times in the previous week). Adjusting for sociodemographics and other confounders, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for sleep dimensions by low and medium vs. high nSC. The mean age of the sample was 47 ± 0.1 years, 52% of those included were women, and 69% were Non-Hispanic (NH)-White. Low vs. high nSC was associated with a higher prevalence of very short sleep (PR = 1.29; (95% CI = 1.23–1.36)). After adjustment, low vs. high nSC was associated with very short sleep duration among NH-White (PR = 1.34 (95% CI = 1.26–1.43)) and NH-Black (PR = 1.14 (95% CI = 1.02–1.28)) adults. Low nSC was associated with shorter sleep duration and sleep disturbances.

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Relationship between Sleep and Hypertension: Findings from the NHANES (2007–2014)

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18157867 ◽

2021 ◽

Vol 18 (15) ◽

pp. 7867

Author(s):

Chunnan Li ◽

Shaomei Shang

Keyword(s):

Blood Pressure ◽

Sleep Disorder ◽

Sleep Duration ◽

Sleep Pattern ◽

Poor Sleep ◽

Sleep Patterns ◽

Short Sleep Duration ◽

Logistic Regression Models ◽

Increased Risk ◽

Definition Of

Background: To evaluate the association of sleep factors (sleep duration, self-reported trouble sleeping, diagnosed sleep disorder) and combined sleep behaviors with the risk of hypertension. Methods: We analyzed 12,166 adults aged 30–79 years who participated in the 2007–2014 National Health and Nutrition Examination Survey. Sleep duration, self-reported trouble sleeping and sleep disorders were collected using a standardized questionnaire. We included three sleep factors (sleep duration, self-reported trouble sleeping and sleep disorder) to generate an overall sleep score, ranging from 0 to 3. We then defined the sleep pattern as “healthy sleep pattern” (overall sleep score = 3), “intermediate sleep pattern” (overall sleep score = 2), and “poor sleep pattern” (0 ≤ overall sleep score ≤ 1) based on the overall sleep score. The definition of hypertension was based on self-reported antihypertensive medication use or biological measurement (systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg). We used weighted logistic regression models to investigate the associations between sleep and hypertension. Results: The overall prevalence of hypertension was 37.8%. A short sleep duration (OR = 1.20, 95% CI: 1.08 to 1.33, p = 0.001), self-reported trouble sleeping (OR = 1.45, 95% CI: 1.28 to 1.65, p < 0.001) and sleep disorder (OR = 1.33, 95% CI: 1.07 to 1.66, p = 0.012) were related to the risk of hypertension. Poor sleep patterns were closely correlated with the risk of hypertension (OR = 1.90, 95% CI: 1.62 to 2.24). Conclusions: Participants with poor sleep patterns were associated with an increased risk for hypertension.

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534 Food Insecurity and Sleep Health by Race/Ethnicity and Age Group in the United States

SLEEP ◽

10.1093/sleep/zsab072.532 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A211-A211

Author(s):

Nyree Riley ◽

Dana Alhasan ◽

W Braxton Jackson ◽

Chandra Jackson

Keyword(s):

Food Security ◽

Food Insecurity ◽

Sleep Duration ◽

Sleep Disturbances ◽

The United States ◽

Poor Sleep ◽

High Food ◽

Short Sleep Duration ◽

Sleep Health ◽

Falling Asleep

Abstract Introduction Food insecurity may influence sleep through poor mental health (e.g., depression) and immune system suppression. Although prior studies have found food insecurity to be associated with poor sleep, few studies have investigated the food security-sleep association among racially/ethnically diverse participants and with multiple sleep dimensions. Methods Using National Health Interview Survey data, we examined overall, age-, sex/gender-, and racial/ethnic-specific associations between food insecurity and sleep health. Food security was categorized as very low, low, marginal, and high. Sleep duration was categorized as very short (<6 hours), short (<7 hours), recommended (7–9 hours), and long (≥9 hours). Sleep disturbances included trouble falling and staying asleep, insomnia symptoms, waking up feeling unrested, and using sleep medication (all ≥3 days/times in the previous week). Adjusting for sociodemographic characteristics and other confounders, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95% confidence intervals (95% CI) for sleep dimensions by very low, low, and marginal vs. high food security. Results The 177,435 participants’ mean age was 47.2±0.1 years, 52.0% were women, 68.4% were Non-Hispanic (NH)-White. Among individuals reporting very low food security, 75.4% had an annual income of <$35,000 and 60.3% were ≥50 years old. After adjustment, very low vs. high food security was associated with a higher prevalence of very short (PR=2.61 [95%CI: 2.44–2.80]) and short (PR=1.66 [95% CI: 1.60–1.72]) sleep duration. Very low vs. high food security was associated with both trouble falling asleep (PR=2.21 [95% CI: 2.12–2.30]) and trouble staying asleep (PR=1.98 [95% CI: 1.91–2.06]). Very low vs. high food security was associated with higher prevalence of very short sleep duration among Asians (PR=3.64 [95% CI: 2.67–4.97]), Whites (PR=2.73 [95% CI: 2.50–2.99]), Blacks (PR=2.03 [95% CI: 1.80–2.31]), and Hispanic/Latinxs (PR=2.65 [95% CI: 2.30–3.07]). Conclusion Food insecurity was associated with poor sleep in a diverse sample of the US population. Support (if any):

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Abstract P108: Habitual Short Sleep Duration Associated with Self-Reported and Objectively-Determined Cardiovascular and Metabolic Disease Risk Factors: Data from NHANES

Circulation ◽

10.1161/circ.129.suppl_1.p108 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Michael A Grandner ◽

Subhajit Chakravorty ◽

Michael Perlis ◽

Linden Oliver ◽

Indira Gurubhagavatula

Keyword(s):

Food Security ◽

Sleep Duration ◽

Home Ownership ◽

Elevated Risk ◽

Outcome Variable ◽

Cardiometabolic Health ◽

Short Sleep Duration ◽

Short Sleep ◽

Long Sleep ◽

Race Ethnicity

Background: Self-reported short and long sleep duration have been associated with adverse cardiometabolic health outcomes in laboratory and epidemiologic studies, but interpretation of such data has been limited by methodological issues. Methods: We analyzed adult 2007-2008 US National Health and Nutrition Examination Survey (NHANES) data (N=5,649). Average self-reported nightly sleep duration was reported and categorized as either very short (<5h), short (5-6h), normal (7-8h), or long (≥9h). Self-reported as well as objective evidence of obesity, diabetes, hypertension, and hyperlipidemia were recorded. Univariate comparisons were conducted across sleep duration categories for all variables. Binary logistic regression analyses were performed using cardiometabolic factor as the outcome variable, and sleep duration category as the predictor variable, before and after adjusting for age, sex, race/ethnicity, acculturation, education, access to insurance, food security, home ownership, smoking, and caffeine use. Results: See table. In adjusted analyses, very short sleep was associated with self-reported hypertension, self-reported hyperlipidemia, objective hyperlipidemia, self-reported diabetes, and objective obesity. Regarding short sleep (5-6hrs), in adjusted analyses, elevated risk was seen for self-reported hypertension self-reported obesity and objective obesity. Regarding long sleep (≥9hrs), no elevated risk was found for any outcomes. Conclusions: Very short and short sleep duration are associated with self-reported and objectively-determined adverse cardiometabolic outcomes, even after adjustment for covariates. Table 1. Unadjusted and Adjusted Odds Ratios (OR) and 95% Confidence Intervals (95%CI) of Associations between Sleep Duration and Cardiometabolic Disease Outcomes *Adjusted analyses include age, sex, race/ethnicity, acculturation, education, insurance, home ownership, food security, smoking, and caffeine

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Abstract P336: The Association Between Goal-Striving Stress, Sleep Duration and Sleep Quality in the Jackson Heart Study

Circulation ◽

10.1161/circ.137.suppl_1.p336 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Loretta Cain ◽

LáShauntá Glover ◽

Dayna Johnson ◽

Mario Sims

Keyword(s):

Sleep Quality ◽

Sleep Duration ◽

Poor Sleep ◽

Jackson Heart Study ◽

Poor Sleep Quality ◽

Short Sleep Duration ◽

Logistic Regression Models ◽

Short Sleep ◽

Goal Striving ◽

Heart Study

Introduction: Research shows that compared to non-Hispanic whites, African Americans (AAs) have poorer sleep quality, lower mean sleep duration, and a higher prevalence of sleep-disordered breathing. AAs also report more frequent exposures to certain stressors over the life course, which may impact physiological processes that may impair sleep. Goal-striving-stress (GSS), the discrepancy between aspiration and achievement, weighted by the subjective probability of success, and the level of disappointment experienced if goals are not reached, may be an important stressor among AA’s that may influence sleep; however this has yet to be explored. The objective of this study was to assess the relationship between GSS and sleep duration and sleep quality in AAs. Hypothesis: We assessed the hypothesis that high (versus low) GSS would be associated with short or long sleep duration and poor sleep quality. Methods: We utilized data from the baseline exam of the Jackson Heart Study (JHS; n=5306), an AA sample of women and men, 35-84 years old. There were a total of 5082 participants in the sample; 63.34% female with a mean age of 55.30 (± 12.75) and mean sleep duration of 6.43 hours (±1.51). The sample was categorized into GSS tertiles: low (n=2121), moderate (n=1716), high (n=1296). Participants self-reported sleep duration (hours) and rated their sleep quality. Sleep duration was categorized as short ( < 6 hours), normal (7 or 8 hours) and long ( > 9 hours). Sleep quality was categorized as high (good/very good/excellent) and low (fair/poor). Logistic regression models were used to obtain odds ratios (OR, 95% confidence interval-CI) to assess the associations of GSS levels with sleep duration and sleep quality categories. Models were adjusted for sex, age, socioeconomic status, health behaviors, discrimination, and health outcomes. Results: Significant results showed that participants who reported high (versus low) GSS had a 29% increased odds [1.29 (1.10, 1.52)] of short (versus normal) sleep after full adjustment. Participants who reported high (versus low) GSS had a 42% increased odds [1.42 (1.20, 1.67)] of low (versus high) sleep quality after full adjustment. Conclusion In conclusion, the deficit between goal aspiration and achievement is associated with short sleep duration and poor sleep quality. Potential interventions should consider the extent to which GSS may contribute to the development of short sleep duration and poor sleep quality.

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0927 Variations in Sleep and Glucose in Adolescents with Type 1 Diabetes

SLEEP ◽

10.1093/sleep/zsaa056.923 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A352-A353

Author(s):

S Griggs ◽

N S Redeker ◽

S Jeon ◽

M Grey

Keyword(s):

Type 1 Diabetes ◽

Blood Glucose ◽

Sleep Duration ◽

Sleep Onset ◽

Glucose Variability ◽

Poor Sleep ◽

Short Sleep Duration ◽

High Blood Glucose ◽

Short Sleep

Abstract Introduction The association between short sleep duration and poorer glycemic control in adolescents ages 10-16 with type 1 diabetes (T1D) is well established. Researchers have used cross-sectional, between-subjects’ methods, with limited focus on the potential intraindividual variation among these variables. The purpose of this analysis was to examine the within person associations between glucose variability indices (J index, low/high blood glucose index, time in range) and sleep characteristics (bedtime, waketime, total sleep time, sleep efficiency, wake after sleep onset [WASO], awakenings, and sleep fragmentation index) in adolescents with T1D. Methods Adolescents monitored their sleep and glucose patterns concurrently for 3-7 days with a wrist actigraph on their non-dominant wrist and either their own continuous glucose monitor (CGM) or a provided blinded CGM. General linear mixed models (GLMM) were used to determine within-person and day level associations. Results The sample included 38 adolescents (M age 13.4±1.8; 37.8% male; M A1C 8.2±1.2%). Average glucose levels were controlled in all GLMMs. Adolescents had earlier waketimes on days when more time was spent in hypoglycemia <70mg/dL (β=-0.15, p<0.001). At the person level, adolescents had greater WASO with more % time spent in severe hypoglycemia <54mg/dL with more severe low blood glucose indices (β=0.35, p<0.01 and β=0.34, p<0.01 respectively). At the daily level, adolescents had greater WASO (β=0.20, p=0.01) and more awakenings (β=0.16, p=0.04) on the days they had more overall glucose variability (J index) and more severe high blood glucose indices (β=0.17, p=0.04), but were less likely to have more % time in hypoglycemia (β=-0.15, p=0.02). Conclusion Glucose variability was positively associated with poor sleep (e.g., WASO and awakenings) in adolescents with T1D both at the daily and intraindividual level. Monitoring over a longer period of time in subsequent studies would allow researchers to determine the within person associations between habitual short sleep duration and glucose variability. Support NINR T32NR0008346 & P20NR014126, Medtronic MiniMed provided CGMs at a discounted rate for the study.

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