Racial/Ethnic Differences in Sleep Disturbances: The Multi-Ethnic Study of Atherosclerosis (MESA)

Chen, Xiaoli; Zee, Phyllis; Wang, Rui; Lutsey, Pamela L.; Javaheri, Sogol; Alcántara, Carmela; Jackson, Chandra L.; Williams, Michelle A.; Redline, Susan

There is limited research on racial/ethnic variation in sleep disturbances. This study aimed to quantify the distributions of objectively
measured sleep disordered breathing (SDB), short sleep duration, poor sleep quality, and self-reported sleep disturbances (e.g., insomnia) across
racial/ethnic groups.
Design: Cross-sectional study.
Setting: Six US communities.
Participants: Racially/ethnically diverse men and women aged 54–93 y in the Multi-Ethnic Study of Atherosclerosis Sleep Cohort (n = 2,230).
Interventions: N/A.
Measurements and Results: Information from polysomnography-measured SDB, actigraphy-measured sleep duration and quality, and selfreported
daytime sleepiness were obtained between 2010 and 2013. Overall, 15.0% of individuals had severe SDB (apnea-hypopnea index [AHI]
≥ 30); 30.9% short sleep duration (< 6 h); 6.5% poor sleep quality (sleep efficiency <85%); and 13.9% had daytime sleepiness. Compared with
Whites, Blacks had higher odds of sleep apnea syndrome (AHI ≥ 5 plus sleepiness) (sex-, age-, and study site-adjusted odds ratio [OR] = 1.78,
95% confidence interval [CI]: 1.20, 2.63), short sleep (OR = 4.95, 95% CI: 3.56, 6.90), poor sleep quality (OR = 1.57, 95% CI: 1.00, 2.48), and
daytime sleepiness (OR = 1.89, 95% CI: 1.38, 2.60). Hispanics and Chinese had higher odds of SDB and short sleep than Whites. Among nonobese
individuals, Chinese had the highest odds of SDB compared to Whites. Only 7.4% to 16.2% of individuals with an AHI ≥ 15 reported a prior
diagnosis of sleep apnea.
Conclusions: Sleep disturbances are prevalent among middle-aged and older adults, and vary by race/ethnicity, sex, and obesity status. The
high prevalence of sleep disturbances and undiagnosed sleep apnea among racial/ethnic minorities may contribute to health disparities.
Keywords: apnea-hypopnea index, body mass index, daytime sleepiness, obesity, polysomnography, race/ethnicity, sleep disordered breathing,
sleep disturbance, sleep duration, sleep quality


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Academic Units
Center for Behavioral Cardiovascular Health
Published Here
November 15, 2016