207 Sociodemographic, Behavioral, and Health-Related Factors Associated with Sleep Among Native Hawaiians and Other Pacific Islanders

Introduction Previous studies have suggested that Native Hawaiians/Pacific Islanders show different associations between sleep and health risks, compared to other groups. The present study evaluated sleep and health risk factors in a nationally-representative sample. Methods Data from the Native Hawaiian and Pacific Islander National Health Interview Survey (NHPI-NHIS), collected by the CDC in 2013, was used for analysis. A total of N=2,124 individuals provided complete data on all variables. Sleep outcomes included hours of sleep (3-12h), days/week difficulty falling asleep, difficulty maintaining sleep, and nonrestorative sleep (ordinal). Weighted regression analyses (linear or ordinal logistic) evaluated whether sleep outcomes were associated with cancer, diabetes, hypertension, stroke, obesity, poor health, depression, anxiety, smoking, alcohol, activity, functional limitations, foregoing medical care due to cost, frequent healthcare utilization, health insurance, and difficulty paying medical bills, in models that also included age, sex, immigrant status, multiracial status, education, employment, income, and relationship status. Results Shorter sleep was associated with older age, earning <$20,000, and being divorced/widowed/separated, and longer sleep was associated with being female and less than high school education. Shorter sleep was also associated with fair health and current drinking. Difficulty falling asleep was positively associated with older age, earning <=$44,999, being divorced/widowed/separated, obesity, worse health, depressed mood, anxiety, daily smoking, former and current drinking, functional limitations, foregoing care, frequent care, and difficulty with bills. Difficulty falling asleep was negatively associated with immigrant status and being retired. Difficulty maintaining sleep was associated with older age, being unmarried but partnered, obesity, worse health, depression, anxiety, daily smoking, current or heavy drinking, being inactive, functional limitations, foregoing care, frequent care, and difficulty with medical bills. Nonrestorative sleep was associated with non-immigrant status, employment, being a homemaker, disability, being unmarried, obesity, worse health, depression, anxiety, daily smoking, former, current, or heavy drinking, inactivity, functional limitations, foregoing care, frequent care, and difficulty with medical bills. Conclusion Short sleep was not significantly associated with common health risk factors seen in other groups. Sleep difficulties, though, were related to a constellation of sociodemographic, socioeconomic, behavioral, and cardiometabolic risks. Further research regarding insomnia as a health risk factor in this population is warranted. Support (if any) R01MD011600, R01DA051321

Integrative Sleep Medicine and Chronic Pain Management

Widespread opioid dependency has spurred growing interest in nonpharmacologic methods of addressing chronic pain. Timely research has established a reciprocal and bidirectional relationship between physical discomfort and sleep disturbances. Thus, comprehensive management of chronic pain necessitates a thorough sleep evaluation because underlying sleep concerns can often thwart otherwise effective treatment strategies. Interventions such as cognitive-behavioral therapy are useful to loosen the psychologic association patients commonly form between chronic pain and nonrestorative sleep. Exercise and mindfulness are among those modalities with the best evidence to simultaneously address both sleep loss and chronic pain. Acupuncture, yoga, and tai chi, as well as certain herbs, can be used to stem the inflammatory cascade that frequently hinders successful treatment. Integrative approaches that promote restful sleep are of increasing importance in the context of managing chronic pain.

Noise sensitivity associated with nonrestorative sleep in Chinese adults: a cross-sectional study

Background Nonrestorative sleep is a common sleep disorder with a prevalence ranging from 1.4 to 35%, and is associated with various psychological and physical health issues. Noise exposure and noise sensitivity have been proposed to contribute to nonrestorative sleep. This study aimed to examine the relationships among noise, noise sensitivity, nonrestorative sleep, and physiological sleep parameters in Chinese adults. Methods A cross-sectional household survey was conducted with randomly selected Chinese adults based on a frame stratified by geographical districts and types of quarters in Hong Kong. We administered a battery of questionnaires, including the Nonrestorative Sleep Scale, the Weinstein Noise Sensitivity Scale, the ENRICHD Social Support Instrument, the Patient Health Questionnaire, and the Perceived Stress Scale to assess nonrestorative sleep, noise sensitivity, social support, somatic symptoms and stress, respectively. Anxiety and depression were evaluated by the Hospital Anxiety and Depression Scale while sociodemographic and lifestyle characteristics were assessed with an investigator-developed sheet. Nocturnal noise level and physiological sleep parameters were measured during nighttime for a week by noise dosimetry and actigraphy, respectively. A structured multiphase linear regression was conducted to estimate associations. Results A total of 500 adults (66.4% female) with an average age of 39 years completed this study. Bivariate regressions showed that age, marital status, occupation, family income, season, exercise, cola and soda consumption, social support, somatic symptoms, stress, depression, noise sensitivity, total sleep time, and awakenings were associated with nonrestorative sleep. In the multivariable analysis, family income, season, exercise, social support, somatic symptoms, stress, and depression remained associated with nonrestorative sleep. Specifically, a one-unit increase of noise sensitivity was associated with 0.08 increase in nonrestorative sleep (95% confidence interval [CI]: 0.01, 0.15, p = 0.023). Nocturnal noise was negatively associated with time in bed (b = − 1.65, 95% CI: − 2.77, − 0.52, p = 0.004), total sleep time (b = − 1.61, 95% CI: − 2.59, − 0.62, p = 0.001), and awakenings (b = − 0.16, 95% CI: − 0.30, − 0.03, p = 0.018), but was not associated with nonrestorative sleep. Conclusions Nonrestorative sleep was predicted by noise sensitivity in addition to family income, season, exercise, social support, somatic symptoms, stress, and depression.

Noise Sensitivity Associated with Nonrestorative Sleep in Chinese Adults: A cross-sectional Study

Background: Nonrestorative sleep (NRS) is associated with various psychological and physical health issues. Noise exposure and noise sensitivity have been proposed to contribute to NRS. This study aimed to examine the relationship between noise, noise sensitivity, NRS, and physiological sleep parameters among Chinese adults.Methods: A cross-sectional household study was conducted with Chinese adults in Hong Kong. We administered a battery of questionnaires, including the Nonrestorative Sleep Scale and the Weinstein Noise Sensitivity Scale for assessing NRS and noise sensitivity, respectively, as well as other instruments for assessing sociodemographics, lifestyle factors, social support, somatic symptoms, stress, anxiety, and depression. Nocturnal noise level was measured for one week by a noise dosimeter. Physiological sleep parameters were also measured by actigraphy during the night-time for a week.Results: A total of 500 (66.4% female) adults with an average age of 39 years participated in this study. There was no significant association between nocturnal noise and NRS (b = -0.09, 95% CI: -0.28, 0.10). However, one unit increase of noise sensitivity was associated with 0.08 increase in NRS (95% confidence interval [CI]: 0.01, 0.15), both on a 0–100 scale, after adjusting for sociodemographics, lifestyle factors, nocturnal noise, social support, somatic symptoms, stress, anxiety, and depression. This relationship remained after adjusting for sleep parameters. Nevertheless, nocturnal noise was significantly negatively associated with total time in bed (b = -1.46, 95% CI: -2.51, -0.40), and total sleep time (b = -1.26, 95% CI: -2.18, -0.34). None of the obtained physiological sleep parameters were associated with NRS.Conclusions: NRS was associated with noise sensitivity while physiological sleep parameters were influenced by nocturnal noise level.

0466 Evolution of Nonrestorative Sleep and Its Interactions with Insomnia Symptoms in a Longitudinal Survey of the American Population

Introduction Nonrestorative sleep (NRS) is one of the sleep disturbances that is under-appreciated. Some studies have set its prevalence at around 10% of the general population but definitions are heterogenous. Despite its frequency, studies that paid attention to that symptom are disparate and have often taken many routes. Our aim is to examine its prevalence, its incidence and its predictive factors. Methods The initial study was carried with 15,929 individuals from 15 US States. The longitudinal study was carried on in eight of these states. A total of 12,218 subjects were interviewed by phone during the first wave (W1) and 10,930 at the second wave (W2) three years apart. The analyses were carried on the subjects who participated in both interviews (N=10,930). NRS was assessed using a series of five questions. The global score determined the presence/absence of NRS. Results A total of 14.7% (CI95%: 14%-15.4%) reported NRS at W1. At follow-up, 13.1% (CI95%: 12.5%-13.7%) reported NRS. The incidence per year was 2.3%. NRS was chronic in 28.9% of cases. NRS occurred alone (i.e. without any other insomnia symptoms) in 5% of the sample at W1 and 3.6% at W2. 22.2% of those with NRS alone at W1 reported other insomnia symptoms at W2. Sleep duration was at least 6h30 in 81.6% of NRS alone cases at W1 and 76.5% at W2. Daytime repercussions were reported by 66.2% of NRS alone at W1 and 52.8% at W2. NRS alone (RR: 2.4) or in combination with insomnia symptoms (RR: 3.4) was one of the strongest predictors for developing a Major Depressive Disorder at W2. Conclusion NRS is a sleep disturbance that has some unique features that distinguish it from insomnia symptoms. Nonetheless, it can have a profound impact on daily life and can lead to further difficulties in other areas if not addressed properly. Support Arrillaga Foundation