Acculturation and depression are associated with short and long sleep duration among Mexican Americans in NHANES 2005-2018

Short sleep duration and daytime outdoor activities effects on adolescents mental health: A stress susceptibility-recovery model analysis

BACKGROUND

Mental health disorders are a growing public health challenge globally. This study aimed to utilize the Stress Susceptibility-Recovery Model to identify the relationship between sleep duration, daytime outdoor activities, and major mental health outcomes among adolescents.

METHODS

Data from the Yunnan Students' Common Disease Survey was analyzed. Multi-factorial logistic regression assessed the impact of each variable on mental health, while subgroup analyses and interaction tests examined the stability of the association between sleep duration, daytime outdoor activity, and mental health. Mendelian Randomization analysis assessed causal effects.

RESULTS

The analysis included 204,158 participants aged 12-18 from 953 surveillance schools. After adjusting for covariates, the prevalence of depressive mood increased from 18.81 % (12-13 years) to 24.89 % (16-18 years); Females had a higher prevalence than males (1:1.36). Senior high school students (26.04 %) had a significantly higher rate than junior high school (21.41 %), and vocational high school students (18.42 %). Students with <2 h of daytime outdoor activity had a higher prevalence of depressive mood (24.40 %) compared to those with 2 or more hours of daytime outdoor activity (19.96 % for 2 h and 19.70 % for 3 or more hours). Short sleep duration mediated the association between reduced daytime outdoor activity and increased depressive mood or affective disorders risk, supporting the Stress Susceptibility-recovery Model.

CONCLUSIONS

Sleep duration and daytime outdoor activity were key determinants of emotional well-being, considering aging and gender disparities.

LIMITATIONS

Potential sampling bias due to differences in baseline characteristics between participants with and without missing data.

Understanding the Stress Process Among Mexican American Adults Aged 50 and Older in the United States

OBJECTIVES

Compared to non-Latino White adults, Mexican Americans in the United States are disproportionally exposed to more social, environmental, and economic stress that increase risk for poor physical and mental health outcomes. Despite this, Mexican Americans tend to benefit from a mortality and mental health advantage indicative of unique resilience and risk factors. We assessed stress exposure and appraisals in eight domains among Mexican Americans compared to non-Latino Whites, and evaluated if compared to high acculturation, low acculturation may be associated with lower stress exposure and appraisal in Mexican Americans.

METHODS

We used data from 2,004 participants (49.4% Mexican American; 50.6% non-Latino White; age range = 50-92). Stress exposure was the total of endorsed events and stress appraisal was the average reported severity. Poisson and linear regression models tested race/ethnic (and acculturation) differences in exposure and appraisal.

RESULTS

There were no differences in the total number of stress exposures between Mexican American and non-Latino White adults (incidence rate ratio = 1.08 [95% CI: 0.99-1.18]), but the types of stress exposures differed. Compared to Mexican Americans, non-Latino Whites consistently endorsed higher stress appraisal (B = 0.23 [SE = 0.04], p < .0001). Mexican Americans with low acculturation reported lower stress appraisal compared to Mexican Americans with high acculturation (B = -0.45 [SE = 0.05], p < .0001).

DISCUSSION

Results indicate that the stress process among Mexican American adults may differ from traditional propositions and highlight the need for more research on the intricacies of the stress process for Mexican Americans in the United States.

How Acculturation Shapes Sleep in Thai Women in the United States During Menopausal Transition: A Mediation and Moderation Analysis

INTRODUCTION

This study examines acculturation's impact on sleep quality, efficiency, and obstructive sleep apnea (OSA) risk among Thai women in the United States transitioning through menopause.

METHODOLOGY

This cross-sectional descriptive study recruited 120 Thai women aged 40 to 65. Questionnaires assessed sleep quality (Pittsburgh Sleep Quality Index [PSQI]), OSA risk (Berlin), menopausal symptoms (Menopause Rating), acculturation (Suinn-Lew Asian Self-Identity Scale), and anxiety (Patient-Reported Outcome Measurement Information System). Data were analyzed using bivariate correlations, multivariable regression, and mediation/moderation analyses.

RESULTS

Mean age was 51.53 (SD = 7.73) years. Most were good sleepers (PSQI <5: 80.83%) and 14.17% at high risk of OSA. Acculturation was associated with better sleep quality (B = -1.086, p = .027) and higher sleep efficiency (B = 2.425, p = .021). Mediation analysis indicated that length of stay in the United States indirectly affected sleep quality (B = -0.022, p = .026) and efficiency (B = 0.051, p = .018) via acculturation.

DISCUSSION

Acculturation significantly affects sleep among Thai women; higher acculturation correlates with better sleep quality and efficiency. Acculturation did not affect OSA risk, suggesting context-specific influences that may benefit sleep through increased social integration. Future research should explore underlying mechanisms in immigrant populations.

Sleep Disorders in South-South Latino Migrants: The Role of Acculturation in the Subjective Assessment of Insomnia Symptoms

Research on sleep disorders among migrant populations is limited, particularly in the context of south-south Latinos migrating to other Latin American countries. Objective: This study aims to analyze the effect that the acculturation process may play on the presence of the subjective assessment of insomnia symptoms in South American migrants in Chile. Methods: Under a cross-sectional design, 1844 South American migrants from Colombia, Venezuela and Peru, currently residing in Chile, were evaluated. Of these, 50% were women with an average age of 35 years. Data were collected using the Insomnia Severity Index (ISI), the EBEA scale for acculturation stress, a scale based on Berry's acculturation strategies, and the anxiety subscale of the DASS-21. Mediation models were employed to assess anxiety as a mediating variable between both acculturation stress and acculturation orientations as well as insomnia symptoms. Results: A home-country-focused orientation was inversely related to insomnia symptoms, whereas a host-country-focused orientation showed a direct association. Anxiety did not mediate either of these relationships. However, acculturation stress was directly associated with the emergence of insomnia symptoms; in this relationship, anxiety partially mediated the negative effect of stress on sleep. Conclusions: There is a complex and dynamic interplay between the acculturation process, insomnia, and anxiety within south-to-south migration in Latin countries. Understanding these relationships could promote culturally sensitive interventions to mitigate the adverse effects of migration-related stressors on sleep health and the overall well-being of Latino migrants.

Exploring How Neighborhood Environment Perceptions Moderate the Health Benefits of Movement Behaviors Among Latinos in Los Angeles

PURPOSE

This study examined how the potential health benefits of movement behaviors - physical activity (PA), sedentary time, and sleep - vary by neighborhood perceptions among Latinos.

DESIGN

Cross-sectional analysis of baseline data from churchgoing Latino adults participating in an ongoing randomized controlled trial to promote PA.

SETTING

East Los Angeles, California, and surrounding neighborhoods.

SAMPLE

Sample of 728 churchgoing Latinos (77% female, mean age 52 years).

MEASURES

Movement behaviors included self-reported leisure-time PA and sleep duration, and accelerometer-based sedentary time. Survey assessed perceived neighborhood crime safety, traffic safety, aesthetics, and social cohesion. Outcomes included self-reported stress, depressive symptoms, diabetes, and hypertension; and objectively-measured body mass index.

ANALYSIS

Linear or logistic regression assessed associations of the movement behaviors with neighborhood measures, and their interactions, in relation to the health outcomes.

RESULTS

Sleep was associated with lower perceived stress [B(SE) = -0.41 (0.09), P < .0001] and major depression [OR, 95% CI = 0.54, 0.42-0.69]. Leisure-time MVPA was associated with lower obesity [OR, 95% CI = 0.60, 0.41-0.88] and sedentary time was associated with higher diabetes [OR, 95% CI = 1.03, 1.00-1.05]. Perceived neighborhood safety from crime, social cohesion, and aesthetics had significant interactions with movement behaviors (P < 0.05) in relation to four outcomes.

CONCLUSION

Interaction models suggest interventions targeting neighborhood crime safety, aesthetics, and social cohesion may be key for maximizing the health benefits of movement behaviors among Latinos.

Acculturation and depression increase trouble sleeping in Mexican immigrant adults

Knowledge of Mexican immigrant sleep health is limited. We investigated the association between acculturation, depression, and having trouble sleeping among a nationally representative sample of Mexican immigrant adults. We used a logistic regression model on cross-sectional data from the 2005-2018 National Health and Nutrition Examination Survey on 2,670 non-U.S.-born Mexican adults aged ≥18 years old. Living in the U.S. for ≥10 years (Adjusted Odds Ratio (AOR) = 2.18; 95% Confidence Interval (CI) = 1.39-3.41), speaking majority English (AOR = 1.62; 95% CI = 1.00-2.64), and mild (AOR = 2.70; 95% CI = 1.82-4.02), moderate (AOR = 3.96; 95% CI = 2.53-6.19), and moderately severe/severe (AOR = 5.75; 95% CI = 3.08-10.75) depression levels were associated with having trouble sleeping. Non-U.S. citizenship status was associated with lower odds of having trouble sleeping (AOR = 0.62; 95% CI = 0.43-0.88). Greater acculturation and depression are associated with higher odds of having trouble sleeping. We provide new knowledge on how citizenship status may be linked to the sleep health of Mexican immigrant communities.

Association between depression severity and trouble sleeping: A population-based study

This study investigates the association between insomnia and depression severity, exploring sleep disturbances in individuals with depression. The aim is to establish a new foundation for managing patients with co-occurring depression and insomnia, using 2015 to 2016 National Health and Nutrition Examination Survey (NHANES) data. We employed a cross-sectional design, using NHANES data from 2015 to 2018. The study included 11,261 participants after excluding incomplete data. Depression severity, assessed using Patient Health Questionnaire-9 (PHQ-9) scores, served as the exposure variable. We considered various demographic and lifestyle factors as covariates in the multivariate adjustment model. Statistical analyses adhered to CDC recommendations, with sample weights incorporated to account for NHANES' complex sample design. Our study, encompassing 19,225 participants, revealed that higher PHQ-9 scores correlated with an increased likelihood of sleep disorders. In the fully adjusted model, a positive association emerged between PHQ-9 scores and trouble sleeping (OR = 3.95, 95% CI: 3.35-4.66, P < .0001). This relationship displayed an inverted U-shaped curve, with an inflection point at 28. Subgroup analysis and interaction tests indicated no reliance on factors such as gender, age, marital status, or BMI for the connection between depression severity and trouble sleeping (all P for interaction > .05). We identified a significant inverted U-shaped correlation between sleep disturbances and depression severity. This underscores the crucial importance of assessing sleep disorder risks in individuals with varying degrees of depression severity, facilitating personalized therapeutic interventions.

Hypertension Prevalence and Related Risk Factors Among Mexican American Adults Are Increasing: National Health and Nutrition Examination Survey 1999 to 2018

BACKGROUND

Acculturation affects hypertension prevalence among Hispanic people, but there have been no recent analyses specifically focused on Mexican American (MA) people. We sought to determine age-adjusted hypertension prevalence, abdominal obesity, and acculturation trends among MA adults and non-Hispanic White adults.

METHODS AND RESULTS

Data from the NHANES (National Health and Nutrition Examination Survey) were analyzed in 2-year increments to observe trends in hypertension and risk factors (age, sex, body mass index, smoking status, abdominal obesity, waist-to-height ratio (WHtR), education, and income). Acculturation was based on three commonly used measures. The sample included 30 920 adults. Age-adjusted hypertension prevalence is higher in MA adults (52.7%) than White adults (48.3%). Hypertension risk factors-age, obesity prevalence, WHtR, acculturation-all significantly increased among MA adults, while smoking declined. Higher acculturation scores increased hypertension likelihood (odds ratio [OR], 1.44 [95% CI, 0.91-1.97]) for MA adults compared with those with lower acculturation scores. White adults with elevated WHtR >0.5 had a 40% higher risk of hypertension than those with WHtR <0.5, but among MA adults, elevated WHtR did not increase risk for hypertension. There was a significant increase in hypertension prevalence among MA adults from 2003 to 2018 at an average biennial rate of 2.23%. There was no change in hypertension prevalence among White adults from 1999 to 2018.

CONCLUSIONS

Over 20 years of NHANES, more highly acculturated MA adults were at greater risk for hypertension, despite declines in smoking and controlling for age, sex, obesity status, education, and income. Finding ways to promote more traditional lifestyle and eating habits for MA adults could be a beneficial approach to reducing hypertension risk factors in this population.

Association between sleep duration and depression in menopausal women: a population-based study

Aims

This research investigated menopausal women older than 50 years to find whether there were any independent relationships between the duration of sleep they got and their prevalence of depression.

Methods

National Health and Nutrition Examination Survey (NHANES) datasets from 2011-2020 were utilized in a cross-sectional study. Using multivariate linear regression models, the linear relationship between sleep duration and depression in menopausal women was investigated. Fitted smoothing curves and thresholds impact evaluation were used to investigate the nonlinear relationship. Then, subgroup analyses were performed according to smoking, drinking alcohol, diabetes, hypertension, heart disease, and moderate activities.

Results

This population-based study included a total of 3,897 menopausal women (mean age 65.47 ± 9.06 years) aged≥50 years; 3,159 had a depression score <10, and 738 had a depression score≥10. After controlling for all covariates, the prevalence of depression was 17% higher among participants with short sleep duration [OR=1.17, 95%CI=(0.65, 1.70), P<0.0001] and 86% [OR=1.86, 95%CI=(1.05, 2.66), P<0.0001] compared to participants with normal sleep duration. In subgroup analyses stratified by smoking and diabetes, the sleep duration and depression scores of non-smokers [β=-0.18, 95%CI= (-0.33, -0.02), P=0.0241] and diabetics were independently negatively correlated [β=-0.32, 95%CI= (-0.63, -0.01), P=0.0416]. Using a two-segment linear regression model, we discovered a U-shaped relationship between sleep duration and depression scores with an inflection point of 7.5 hours. Less than 7.5 hours of sleep was associated with an increased risk of developing depression [β=-0.81, 95%CI= (-1.05, -0.57), P<0.001]. However, sleeping more than 7.5 hours per night increased the risk of depression considerably [β=0.80, 95%CI= (0.51, 1.08), P<0.001].

Conclusions

Depression is associated with sleep duration in menopausal women. Insufficient or excessive sleep may increase the risk of depression in menopausal women.