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Sofer T, Kurniansyah N, Murray M, Ho YL, Abner E, Esko T, Huffman JE, Cho K, Wilson PWF, Gottlieb DJ. Genome-wide association study of obstructive sleep apnoea in the Million Veteran Program uncovers genetic heterogeneity by sex. EBioMedicine 2023; 90:104536. [PMID: 36989840 PMCID: PMC10065974 DOI: 10.1016/j.ebiom.2023.104536] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Genome-wide association studies (GWAS) for obstructive sleep apnoea (OSA) are limited due to the underdiagnosis of OSA, leading to misclassification of OSA, which consequently reduces statistical power. We performed a GWAS of OSA in the Million Veteran Program (MVP) of the U.S. Department of Veterans Affairs (VA) healthcare system, where OSA prevalence is close to its true population prevalence. METHODS We performed GWAS of 568,576 MVP participants, stratified by biological sex and by harmonized race/ethnicity and genetic ancestry (HARE) groups of White, Black, Hispanic, and Asian individuals. We considered both BMI adjusted (BMI-adj) and unadjusted (BMI-unadj) models. We replicated associations in independent datasets, and analysed the heterogeneity of OSA genetic associations across HARE and sex groups. We finally performed a larger meta-analysis GWAS of MVP, FinnGen, and the MGB Biobank, totalling 916,696 individuals. FINDINGS MVP participants are 91% male. OSA prevalence is 21%. In MVP there were 18 and 6 genome-wide significant loci in BMI-unadj and BMI-adj analyses, respectively, corresponding to 21 association regions. Of these, 17 were not previously reported in association with OSA, and 13 replicated in FinnGen (False Discovery Rate p-value < 0.05). There were widespread significant differences in genetic effects between men and women, but less so across HARE groups. Meta-analysis of MVP, FinnGen, and MGB biobank revealed 17 additional, previously unreported, genome-wide significant regions. INTERPRETATION Sex differences in genetic associations with OSA are widespread, likely associated with multiple OSA risk factors. OSA shares genetic underpinnings with several sleep phenotypes, suggesting shared aetiology and causal pathways. FUNDING Described in acknowledgements.
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Affiliation(s)
- Tamar Sofer
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Nuzulul Kurniansyah
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Michael Murray
- Massachusetts Veterans Epidemiology Research and Information Center, VA Healthcare System, Boston, MA, USA
| | - Yuk-Lam Ho
- Massachusetts Veterans Epidemiology Research and Information Center, VA Healthcare System, Boston, MA, USA
| | - Erik Abner
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Tõnu Esko
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Jennifer E Huffman
- Massachusetts Veterans Epidemiology Research and Information Center, VA Healthcare System, Boston, MA, USA; VA Palo Alto Health Care System, Palo Alto, CA, USA; Palo Alto Veterans Institute for Research, Palo Alto, CA, USA
| | - Kelly Cho
- Massachusetts Veterans Epidemiology Research and Information Center, VA Healthcare System, Boston, MA, USA; Division of Aging, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | | | - Daniel J Gottlieb
- Division of Sleep and Circadian Disorders, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Massachusetts Veterans Epidemiology Research and Information Center, VA Healthcare System, Boston, MA, USA
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Papadopoulos D, Sosso FAE. Socioeconomic status and sleep health: a narrative synthesis of 3 decades of empirical research. J Clin Sleep Med 2023; 19:605-620. [PMID: 36239056 PMCID: PMC9978435 DOI: 10.5664/jcsm.10336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 10/03/2022] [Accepted: 10/04/2022] [Indexed: 12/24/2022]
Abstract
STUDY OBJECTIVES This review aims to assess the association between socioeconomic status (SES) and sleep health in the general population and the mediating effects of lifestyle and mental and physical health in this relationship. METHODS Observational studies testing the independent association between objective or subjective SES indicators and behavioral/physiological or clinical sleep health variables in the general population were included. PubMed/MEDLINE was searched for reports published from January 1990 to December 2019. The direction of effect was used as the primary effect measure, testing the hypothesis that low SES is associated with poor sleep health outcomes. Results are presented in the form of direction effect plots and synthesized as binomial proportions. RESULTS Overall, 336 studies were identified. A high proportion of effects at the expected direction was noted for measures of sleep continuity (100% for sleep latency, 50-100% for awakenings, 66.7-100% for sleep efficiency), symptoms of disturbed sleep (75-94.1% for insomnia, 66.7-100% for sleep-disordered breathing, 60-100% for hypersomnia), and general sleep satisfaction (62.5-100%), while the effect on sleep duration was inconsistent and depended on the specific SES variable (92.3% for subjective SES, 31.7% for employment status). Lifestyle habits, chronic illnesses, and psychological factors were identified as key mediators of the SES-sleep relationship. CONCLUSIONS Unhealthy behaviors, increased stress levels, and limited access to health care in low-SES individuals may explain the SES-sleep health gradient. However, the cross-sectional design of most studies and the high heterogeneity in employed measures of SES and sleep limit the quality of evidence. Further research is warranted due to important implications for health issues and policy changes. CITATION Papadopoulos D, Etindele Sosso FA. Socioeconomic status and sleep health: a narrative synthesis of 3 decades of empirical research. J Clin Sleep Med. 2023;19(3):605-620.
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Young DR, Hong BD, Lewis KH, Paz SR, Bhakta BB, Macias M, Crawford CL, Drewnowski A, Ji M, Moore DD, Shen E, Murali SB, Coleman KJ. The association of 1-year weight loss from bariatric surgery and self-reported sleep: a prospective cohort. Obesity (Silver Spring) 2022; 30:2307-2316. [PMID: 36321277 PMCID: PMC9913885 DOI: 10.1002/oby.23543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 07/05/2022] [Accepted: 07/14/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study examined the association of weight loss following bariatric surgery with self-reported sleep quality after accounting for other sleep-related factors. METHODS Participants were from the Bariatric Experience Long Term (BELONG) study. Participants completed a survey up to 6 months before surgery and approximately 1 year after surgery. The Pittsburgh Sleep Quality Index (PSQI) was used to measure sleep quality. One-year percentage total weight loss (%TWL) was determined from electronic medical records. Covariates included demographics, Charlson Comorbidity Index, geocoded variables to assess neighborhood quality, and physical activity. The authors assessed the association between %TWL at 1 year and PSQI component scores with separate cumulative logit models. RESULTS There were 997 participants in the analytic cohort. Participants were 86.2% women, 37.0% Hispanic, and 13.7% Black adults. Mean one-year %TWL was 26.3 (SD 8.7). Each 1% increase in %TWL was associated with a 3% better daytime dysfunction score (odds ratio = 1.03; 95% CI: 1.02-1.05) and a 2% better sleep quality score (odds ratio = 1.02; 95% CI: 1.00-1.03). No significant differences were found for the other PSQI components. CONCLUSIONS Weight loss from bariatric surgery was associated with better self-reported sleep at 1 year. For people undergoing bariatric surgery, there may be an added benefit of better sleep.
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Affiliation(s)
- Deborah R. Young
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Benjamin D. Hong
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Kristina H. Lewis
- Division of Public Health Sciences, Department of Epidemiology & Prevention, Wake Forest University Health Sciences, Winston-Salem, North Carolina, USA
| | - Silvia R. Paz
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Bhumi B. Bhakta
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Mayra Macias
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Cecelia L. Crawford
- Regional Nursing Research Program, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Adam Drewnowski
- Center for Public Health Nutrition, University of Washington, Seattle, Washington, USA
| | - Ming Ji
- College of Nursing, University of South Florida, Tampa, Florida, USA
| | - Darren D. Moore
- Marriage and Family Therapy Program, The Family Institute, Northwestern University, Evanston, Illinois, USA
| | - Ernest Shen
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
| | - Sameer B. Murali
- Center for Obesity Medicine & Metabolic Performance, Department of Surgery, University of Texas McGovern Medical School, Houston, Texas, USA
| | - Karen J. Coleman
- Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California, USA
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Towards A Socioeconomic Model of Sleep Health among the Canadian Population: A Systematic Review of the Relationship between Age, Income, Employment, Education, Social Class, Socioeconomic Status and Sleep Disparities. Eur J Investig Health Psychol Educ 2022; 12:1143-1167. [PMID: 36005229 PMCID: PMC9407487 DOI: 10.3390/ejihpe12080080] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 07/20/2022] [Accepted: 07/22/2022] [Indexed: 12/05/2022] Open
Abstract
A better understanding of the contribution of the socioeconomic status (SES) in sleep health could guide the development of population-based interventions aiming to reduce “the silent public health issue” that are sleep disturbances. PRISMA was employed to identify relevant studies having examined the association between social class, social capital, education, income/assets, occupation/employment status, neighborhood deprivation and sleep health. Sixteen cross-sectional and three longitudinal studies were selected, having sampled 226,029 participants aged from 2 months to 85 years old. Findings showed that: (1) sleep health disparities among children and adolescent are strongly correlated to parental socioeconomic indicators; (2) poor parental income, poor family SES and poor parental education are associated with higher sleep disturbances among children and adolescents; (3) lower education is a predictor of increased sleep disturbances for adults; (4) low SES is associated with high sleep disturbances in adults and old people and; (5) low income and full-time employment was significantly associated with short sleep among adults and old people. In conclusion, sleep health should be an important public health target. Such intervention would be beneficial for populational health, for all taxpayers and public administrations, which would see a reduction in absenteeism and productivity losses attributable to sleep-related health problems in the global economy.
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Ahn S, Lobo JM, Logan JG, Kang H, Kwon Y, Sohn MW. A scoping review of racial/ethnic disparities in sleep. Sleep Med 2021; 81:169-179. [PMID: 33713923 DOI: 10.1016/j.sleep.2021.02.027] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 02/08/2021] [Accepted: 02/11/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Despite remarkable achievements in ensuring health equity, racial/ethnic disparities in sleep still persist and are emerging as a major area of concern. Accumulating evidence has not yet been well characterized from a broad perspective. We conducted a scoping review of studies on sleep disparities by race/ethnicity to summarize characteristics of existing studies and identify evidence gaps. METHODS We searched PubMed, CINAHL, PsycINFO, and Web of Science databases for studies of racial/ethnic disparities in sleep. Studies that met inclusion criteria were retrieved and organized in a data charting form by study design, sleep measuring methods, sleep features, and racial/ethnic comparisons. RESULTS One hundred sixteen studies were included in this review. Most studies focused on disparities between Whites and Blacks. Disproportionately fewer studies examined disparities for Hispanic, Asian, and other racial/ethnic groups. Self-reported sleep was most frequently used. Sleep duration, overall sleep quality, and sleep disordered breathing were frequently studied, whereas other features including sleep efficiency, latency, continuity, and architecture were understudied, particularly in racial minority groups in the US. Current study findings on racial/ethnic disparities in most of sleep features is mixed and inconclusive. CONCLUSIONS This review identified significant evidence gaps in racial/ethnic disparities research on sleep. Our results suggest a need for more studies examining diverse sleep features using standardized and robust measuring methods for more valid comparisons of sleep health in diverse race/ethnicity groups.
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Affiliation(s)
- Soojung Ahn
- School of Nursing, University of Virginia, Charlottesville, VA, USA
| | - Jennifer M Lobo
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Jeongok G Logan
- School of Nursing, University of Virginia, Charlottesville, VA, USA
| | - Hyojung Kang
- College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Younghoon Kwon
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Min-Woong Sohn
- Department of Health Management and Policy, College of Public Health, University of Kentucky, Lexington, KY, USA.
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Sosso FAE, Khoury T. Socioeconomic status and sleep disturbances among pediatric population: a continental systematic review of empirical research. Sleep Sci 2021; 14:245-256. [PMID: 35186203 PMCID: PMC8848532 DOI: 10.5935/1984-0063.20200082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 11/24/2020] [Indexed: 11/20/2022] Open
Abstract
To this day, no consensus has been established on the definition and the conceptualization of the socioeconomic status (SES), since all the available studies on the relation between SES and health did not use the same conceptual framework and operationalization to assess SES. While literature reported that SES markers (such as income, social support networks, education, employment or occupation) influence the health of populations by shaping living conditions; empirical research does not tell us which SES markers affect more strongly the sleep components of the individuals, as well as which sleep disorders (SD) are affected and how. Even though several original studies have tried to assess how changes in socioeconomic status of parents may affect the psychosocial environment and mental health of an individual directly or through his community, no systematic reviews on the influence of SES on children's sleep are available. This systematic review make an update on the different measures of SES and sleep disturbances used for pediatric population across the different regions of the world. Recommendations for a future standardization of SES measures is proposed, for a better understanding of its influence on sleep disturbances.
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Affiliation(s)
- FA Etindele Sosso
- Department on Global Health and Ecoepidemiology,Redavi Institute, Montréal, Canada. ,Corresponding author: FA Etindele Sosso E-mail:
| | - Tommy Khoury
- Université de Montréal, Faculté de Médecine - Montréal - Québec - Canada
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Petrov ME, Long DL, Grandner MA, MacDonald LA, Cribbet MR, Robbins R, Cundiff JM, Molano JR, Hoffmann CM, Wang X, Howard G, Howard VJ. Racial differences in sleep duration intersect with sex, socioeconomic status, and U.S. geographic region: The REGARDS study. Sleep Health 2020; 6:442-450. [PMID: 32601040 DOI: 10.1016/j.sleh.2020.05.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 04/08/2020] [Accepted: 05/21/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Short and long sleep duration are associated with poor health outcomes and are most prevalent among racial/ethnic minorities. Few studies have investigated the intersection of other sociodemographic characteristics with race/ethnicity on sleep duration prevalence. DESIGN Longitudinal retrospective analysis of continental U.S. cohort, the REasons for Geographic And Racial Differences in Stroke (REGARDS) PARTICIPANTS: Black (n = 7,547) and white (n = 12,341) adults, 56% women, ≥45 years MEASUREMENTS: At baseline (2003-07), participants reported age, sex, race, education, income, marital status, U.S. region, and employment status. The weighted average of reported sleep duration on weekdays and weekends, assessed at follow-up (2008-10), was categorized as <6, 6.0-6.99, 7.0-7.99 [reference], 8.0-8.99, and ≥9 h. Multinomial logistic regression models examined the independent and multivariable associations of sociodemographic factors with sleep duration. Interactions terms between race with education, income, region, and sex were examined. RESULTS Average sleep duration was 7.0 h (SD=1.3). Prevalence of short (<6 h) and long (≥9 h) sleep duration was 11.4% (n = 2,260) and 7.0% (n = 1,395), respectively. In the multivariable model, interactions terms race*income, race*sex, and race*region were significant (P < .05). Relative to white adults, black adults, were most likely to have short sleep duration. The magnitude of that likelihood increased across greater levels of household income, but with greatest odds among black adults living outside of the Southeast and Appalachian United States, particularly for men (≥$75k; black men OR = 5.47, 95%CI: 3.94,7.54; black women OR = 4.28, 95%CI: 3.08, 5.96). CONCLUSIONS Race in the context of socioeconomic, sex, and regional factors should be examined as key modifiers of sleep duration.
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Affiliation(s)
- Megan E Petrov
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA.
| | - D Leann Long
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Leslie A MacDonald
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA (see disclaimer below)
| | - Matthew R Cribbet
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
| | - Rebecca Robbins
- Harvard Medical School, Harvard University, Cambridge, MA, USA; Division of Sleep and Circadian Disorders, Brigham & Women's Hospital, Boston, MA, USA
| | - Jenny M Cundiff
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
| | - Jennifer R Molano
- Department of Neurology, University of Cincinnati, Cincinnati, OH, USA
| | - Coles M Hoffmann
- Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, AZ, USA
| | - Xuewen Wang
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - George Howard
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Virginia J Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
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Bazargan M, Mian N, Cobb S, Vargas R, Assari S. Insomnia Symptoms among African-American Older Adults in Economically Disadvantaged Areas of South Los Angeles. Brain Sci 2019; 9:E306. [PMID: 31684049 PMCID: PMC6896036 DOI: 10.3390/brainsci9110306] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Revised: 10/31/2019] [Accepted: 10/31/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Although psychosocial and health factors impact insomnia symptoms, less is known about these effects in economically disadvantaged African-American older adults. AIMS This study investigated social and health determinants of insomnia symptoms among economically disadvantaged African-American older adults. METHODS This survey enrolled 398 African-American older adults (age ≥ 65 years) from economically disadvantaged areas of South Los Angeles. Gender, age, educational attainment, financial difficulty, number of chronic diseases, self-rated health, pain intensity, and depression were covariates. Total insomnia, insomnia symptoms, and insomnia impact were our outcomes. Linear regression was applied for data analysis. RESULTS Based on linear regression, higher financial difficulty (B = 0.48, 95% CI = 0.35-0.61), smoking status (B = 1.64, 95% CI = 0.13-3.16), higher pain intensity (B = 0.39, 95% CI = 0.11-0.67), higher number of chronic diseases (B = 0.34, 95% CI = 0.05-0.64), and more depressive symptoms (B = 0.35, 95% CI = 0.12-0.57) were associated with a higher frequency of insomnia symptoms. Based on a logistic regression model, lower age (B = 0.91, 95% CI = 0.91-1.00) and high financial difficulty (OR = 1.15, 95% CI = 1.08-1.24), pain (OR = 2.08, 95% CI = 1.14-3.80), chronic disease (OR = 1.27, 95% CI = 1.07-1.51) and depression (OR = 2.38, 95% CI = 1.22-4.65) were associated with higher odds of possible clinical insomnia. We also found specific predictors for insomnia symptoms and insomnia impact. CONCLUSIONS Among African-American older adults in economically disadvantaged areas of South Los Angeles, insomnia symptoms co-occur with other economic, physical, and mental health challenges such as financial difficulty, smoking, multimorbidity, pain, and depression. There is a need to address sleep as a component of care of economically disadvantaged African-American older adults who have multiple social and health challenges.
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Affiliation(s)
- Mohsen Bazargan
- Department of Family Medicine, Charles R Drew University of Medicine and Science (CDU), Los Angeles, CA 90059, USA.
- Department of Family Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA.
| | - Nadia Mian
- Department of Family Medicine, Charles R Drew University of Medicine and Science (CDU), Los Angeles, CA 90059, USA.
| | - Sharon Cobb
- School of Nursing, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
| | - Roberto Vargas
- Department of Family Medicine, Charles R Drew University of Medicine and Science (CDU), Los Angeles, CA 90059, USA.
- Urban Health Institute, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA.
| | - Shervin Assari
- Department of Family Medicine, Charles R Drew University of Medicine and Science (CDU), Los Angeles, CA 90059, USA.
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Ruff RR, Ng J, Jean-Louis G, Elbel B, Chaix B, Duncan DT. Neighborhood Stigma and Sleep: Findings from a Pilot Study of Low-Income Housing Residents in New York City. Behav Med 2018; 44:48-53. [PMID: 27492685 DOI: 10.1080/08964289.2016.1203754] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The primary objective of this study was to investigate the relationship between neighborhood stigma and sleep in a sample of low-income housing residents in New York City. Data were derived from the NYC Low-Income Housing, Neighborhoods, and Health Study (N = 120). Adults living in low-income housing completed a survey consisting of measures of neighborhood stigma, sleep quality, and sleep duration. Neighborhood stigma and sleep were self-reported. Associations between neighborhood stigma and sleep health were analyzed using generalized linear models with cluster variance estimation. Multivariable models adjusted for age, gender, race/ethnicity, income, education, employment status, obesity, the census block percentage of non-Hispanic black residents, and the census block percentage median household income. Results indicate that a reported negative media perception of the neighborhood was negatively associated with sleep quality and duration (p < 0.01). However, additional research is needed to explore neighborhood stigma as it relates to sleep.
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Affiliation(s)
- Ryan Richard Ruff
- a New York University College of Dentistry and New York University College of Global Public Health
| | - Jeannie Ng
- b New York University College of Global Public Health
| | | | - Brian Elbel
- d New York University School of Medicine and New York University Wagner Graduate School of Public Service
| | - Basile Chaix
- e Sorbonne Universités and Pierre Louis Institute of Epidemiology and Public Health
| | - Dustin T Duncan
- f New York University School of Medicine, New York University College of Global Public Health, and New York University Center for Data Science
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Paech GM, Crowley SJ, Eastman CI. Sleep and cognitive performance of African-Americans and European-Americans before and during circadian misalignment produced by an abrupt 9-h delay in the sleep/wake schedule. PLoS One 2017; 12:e0186843. [PMID: 29073187 PMCID: PMC5658102 DOI: 10.1371/journal.pone.0186843] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Accepted: 10/09/2017] [Indexed: 01/12/2023] Open
Abstract
We conducted two studies of circadian misalignment in non-Hispanic African and European-Americans. In the first, the sleep/wake (light/dark) schedule was advanced 9 h, similar to flying east, and in the second these schedules were delayed 9 h, similar to flying west or sleeping during the day after night work. We confirmed that the free-running circadian period is shorter in African-Americans compared to European-Americans, and found differences in the magnitude and direction of circadian rhythm phase shifts which were related to the circadian period. The sleep and cognitive performance data from the first study (published in this journal) documented the impairment in both ancestry groups due to this extreme circadian misalignment. African-Americans slept less and performed slightly worse during advanced/misaligned days than European-Americans. The current analysis is of sleep and cognitive performance from the second study. Participants were 23 African-Americans and 22 European-Americans (aged 18-44 years). Following four baseline days (8 h time in bed, based on habitual sleep), the sleep/wake schedule was delayed by 9 h for three days. Sleep was monitored using actigraphy. During the last two baseline/aligned days and the first two delayed/misaligned days, beginning 2 h after waking, cognitive performance was assessed every 3 h using the Automated Neuropsychological Assessment Metrics (ANAM) battery. Mixed model ANOVAs assessed the effects of ancestry (African-American or European-American) and condition (baseline/aligned or delayed/misaligned) on sleep and performance. There was decreased sleep and impaired cognitive performance in both ancestry groups during the two delayed/misaligned days relative to baseline/aligned days. Sleep and cognitive performance did not differ between African-Americans and European-Americans during either baseline/aligned or delayed/misaligned days. While our previous work showed that an advance in the sleep/wake schedule impaired the sleep of African-Americans more than European-Americans, delaying the sleep/wake schedule impaired the sleep and cognitive performance of African-Americans and European-Americans equally.
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Affiliation(s)
- Gemma M. Paech
- Biological Rhythms Research Laboratory, Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Stephanie J. Crowley
- Biological Rhythms Research Laboratory, Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Charmane I. Eastman
- Biological Rhythms Research Laboratory, Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
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Paech GM, Crowley SJ, Fogg LF, Eastman CI. Advancing the sleep/wake schedule impacts the sleep of African-Americans more than European-Americans. PLoS One 2017; 12:e0186887. [PMID: 29059251 PMCID: PMC5653363 DOI: 10.1371/journal.pone.0186887] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 10/09/2017] [Indexed: 12/16/2022] Open
Abstract
There are differences in sleep duration between Blacks/African-Americans and Whites/European-Americans. Recently, we found differences between these ancestry groups in the circadian system, such as circadian period and the magnitude of phase shifts. Here we document the role of ancestry on sleep and cognitive performance before and after a 9-h advance in the sleep/wake schedule similar to flying east or having a large advance in sleep times due to shiftwork, both of which produce extreme circadian misalignment. Non-Hispanic African and European-Americans (N = 20 and 17 respectively, aged 21-43 years) were scheduled to four baseline days each with 8 h time in bed based on their habitual sleep schedule. This sleep/wake schedule was then advanced 9 h earlier for three days. Sleep was monitored using actigraphy. During the last two baseline/aligned days and the first two advanced/misaligned days, beginning 2 h after waking, cognitive performance was measured every 3 h using the Automated Neuropsychological Assessment Metrics (ANAM) test battery. Mixed model ANOVAs assessed the effects of ancestry (African-American or European-American) and condition (baseline/aligned or advanced/misaligned) on sleep and cognitive performance. There was decreased sleep and impaired performance in both ancestry groups during the advanced/misaligned days compared to the baseline/aligned days. In addition, African-Americans obtained less sleep than European-Americans, especially on the first two days of circadian misalignment. Cognitive performance did not differ between African-Americans and European-Americans during baseline days. During the two advanced/misaligned days, however, African-Americans tended to perform slightly worse compared to European-Americans, particularly at times corresponding to the end of the baseline sleep episodes. Advancing the sleep/wake schedule, creating extreme circadian misalignment, had a greater impact on the sleep of African-Americans than European-Americans. Ancestry differences in sleep appear to be exacerbated when the sleep/wake schedule is advanced, which may have implications for individuals undertaking shiftwork and transmeridian travel.
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Affiliation(s)
- Gemma M. Paech
- Biological Rhythms Research Laboratory, Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Stephanie J. Crowley
- Biological Rhythms Research Laboratory, Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Louis F. Fogg
- Biological Rhythms Research Laboratory, Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Charmane I. Eastman
- Biological Rhythms Research Laboratory, Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
- * E-mail:
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12
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Ramos AR, Tarraf W, Daviglus M, Davis S, Gallo LC, Mossavar-Rahmani Y, Penedo FJ, Redline S, Rundek T, Sacco RL, Sotres-Alvarez D, Wright CB, Zee PC, González HM. Sleep Duration and Neurocognitive Function in the Hispanic Community Health Study/Study of Latinos. Sleep 2016; 39:1843-1851. [PMID: 27450689 DOI: 10.5665/sleep.6166] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2015] [Accepted: 06/11/2016] [Indexed: 01/17/2023] Open
Abstract
STUDY OBJECTIVES To evaluate the association between sleep duration and neurocognitive function in a representative sample of middle-aged to older Hispanic/Latino adults in the US. We tested the hypothesis that sleep duration has a nonlinear, inverted U-shaped association with neurocognitive function. METHODS We performed a cross-sectional analysis from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) participants ages 45-74 years (n = 8,676). HCHS/SOL is a community-based cohort from four US urban areas sampled using a probability design from 2008-2011. Self-reported sleep duration was calculated as a weighted average of the difference between habitual wake and bedtimes assessed by separate questions for weekdays and weekends. Neurocognitive function was measured with standardized scores for Word (Phonemic) Fluency (WF), Brief-Spanish English Verbal learning test (B-SEVLT), and Digit Symbol Substitution (DSS) tests. RESULTS The mean age was 56.5 years; 55% were women; and 40.4% had less than high school education. Average sleep duration was 7.8 ± 1.7 hours. There was an inverted U-shaped association with sleep duration and WF, B-SEVLT sum, and the DSS, with no association with B-SEVLT delayed-recall. Participants with intermediate sleep duration had the best neurocognitive function, while long sleepers had worse neurocognitive function adjusting for demographic, behavioral, and medical factors, daytime sleepiness, and use of sleep medications. CONCLUSIONS Sleep duration had curvilinear inverted U-shaped associations with neurocognitive function, with worse scores among participants with longer sleep duration. These findings may provide a framework to further examine sleep duration in the prevention and treatment of neurocognitive disorders.
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Affiliation(s)
- Alberto R Ramos
- Department of Neurology, University of Miami, Miller School of Medicine, Miami, FL
| | | | - Martha Daviglus
- University of Illinois at Chicago, Chicago, IL.,Northwestern University, Chicago, IL
| | - Sonia Davis
- Collaborative Studies Coordinating Center Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | | | | | | | | | - Tatjana Rundek
- Department of Neurology, University of Miami, Miller School of Medicine, Miami, FL
| | - Ralph L Sacco
- Department of Neurology, University of Miami, Miller School of Medicine, Miami, FL
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | - Clinton B Wright
- Department of Neurology, University of Miami, Miller School of Medicine, Miami, FL
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13
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Paine SJ, Gander PH. Explaining ethnic inequities in sleep duration: a cross-sectional survey of Māori and non-Māori adults in New Zealand. Sleep Health 2016; 2:109-115. [DOI: 10.1016/j.sleh.2016.01.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2015] [Revised: 01/12/2016] [Accepted: 01/26/2016] [Indexed: 01/13/2023]
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