Ethnicity, sleep duration, and sleep satisfaction

Participation in community seniors' organizations and mental health among retired adults in urban China: The mediating role of interpersonal needs

Purpose

This study aimed to investigate the association between participation in community seniors' organizations (CSOs) and mental health among retired adults in urban China, and illustrate the causal mechanism.

Methods

We collected data on participation from a community seniors' organization and mental health survey in Shenzhen City, China, in July 2022. The survey used a two-stage cluster sample design, based on administrative divisions as the primary sampling unit and communities as the second sampling unit, where retired adults were randomly sampled. The inclusion criteria were individuals >60 years old (the mandatory age for retirement in China) or women who retired early at the age of 45 years. We used three multivariable regression models to estimate the effects of participation in CSOs on mental health. Furthermore, we used structural equation models to examine the mediator of acquired interpersonal needs in the association between CSOs participation and mental health.

Results

The study examined the values of CSOs, generated explicitly for older adults and explained how participation in such organizations benefits retired adults' mental health. Mental health is defined in three dimensions: aggregate mental health, positive emotions, and negative emotions. The results show that constituting social networks with like-minded individuals and perceiving interpersonal needs are the two main benefits of CSOs on mental health. The retired individual who participated in CSOs with a higher level of diversity and frequency, joined specific types such as health- and study-related CSOs, could receive more interpersonal needs and were probably mentally healthier. The mediating mechanism of interpersonal needs associated with participation in mental health was significant. Besides, mental health is generally affected by physical health, sleep quality, and socioeconomic status.

Conclusion

This study suggested that CSOs have expanded the social interaction channels of retired adults and affected their mental health by providing basic interpersonal needs such as inclusion, dominance, and affection. Among the types of CSOs, health and study organizations might enhance mental health most effectively, while semi-official organizations have no effect.

Trait Mindfulness and Physical Health among Chinese Middle-Older Adults: The Mediating Role of Mental Health

Few studies have focused on the specific effects of trait mindfulness on physical health status, especially from a resilient aging perspective. This study examined the mediating role of mental health in the association between trait mindfulness and physical health status among middle-older adults in urban China. The participants included 188 individuals who were recruited from a community senior university and five community senior care centers. The findings reveal: (1) trait mindfulness has a strong effect on two physical health indicators (self-rated physical health and subjective sleep quality); (2) mental health is a significant mediator in the relationship between trait mindfulness and physical health status; and (3) the mediation role of mental health is more evident in the self-rated physical health model (24.15%) than subjective sleep quality (18.10%). This study improves our knowledge of how trait mindfulness can lead to a better physical health in middle-older adults and can lead to the development of social value communication and effective prevention.

Longitudinal association between short sleep, body weight, and emotional and learning problems in Hispanic and Caucasian children

STUDY OBJECTIVE

To determine the impact of lower amounts of childhood sleep assessed by polysomnogram on development of obesity, being anxious or depressed, or having learning problems 5 years later.

DESIGN

Prospective cohort.

PARTICIPANTS

Subjects were 304 community participants from the Tucson Children's Assessment of Sleep Apnea study, aged 6-12 years old at baseline.

MEASUREMENTS AND RESULTS

Children were classified according to baseline sleep as those who slept ≥ 9 h/night, those who slept > 7.5 to < 9 h/night, and those who slept ≤ 7.5 h/night. Odds of overweight/obese (≥ 85(th) BMI percentile), obese (≥ 95(th) BMI percentile), anxious or depressed, and learning problems at follow-up were assessed according to baseline sleep categories. Children who slept ≤ 7.5 h/night had higher odds of being obese (OR = 3.3, P < 0.05) at follow-up than children who slept ≥ 9 h/night. Borderline significance for overweight/obese (OR = 2.2, P < 0.1), anxious or depressed (OR = 3.3, P < 0.1), and having learning problems (OR = 11.1, P < 0.1) were seen for children who slept ≤ 7.5 h/night as compared to those who slept ≥ 9 h/night. A mean increase in BMI of 1.7 kg/m(2) (P = 0.01) over the 5 years of follow-up was seen for children who slept ≤ 7.5 h/night compared to those who slept ≥ 9 h/night. These relationships did not differ between Hispanic and Caucasian children.

CONCLUSIONS

Children with reduced amounts of sleep (≤ 7.5 h/night) had an increased risk for higher body weight in early adolescence. Similarly, children who slept ≤ 7.5 h/night had higher risk of being anxious or depressed or having learning problems in early adolescence.

Elevated sleep disturbance among blacks in an urban family medicine practice

PURPOSE

Blacks experience a number of health disparities. Sleep disturbances contribute to poor health. This preliminary study explores whether a disparity in sleep disturbances exists among blacks compared with whites and others.

METHODS

A cross-sectional study was conducted in a sample (n = 92) of urban primary care patients (52% black, 46% white, and 2% other) from a university-based family medicine practice. Mean (SD) age was 51.9 years (8.9 years). Participants completed the Pittsburgh Sleep Quality Index, the Center for Epidemiologic Studies Depression Scale, Revised, and a checklist of chronic health conditions.

RESULTS

The rate of clinically meaningful sleep disturbance was 71%. In bivariate logistic regressions, black race was associated with sleep disturbance (odds ratio [OR], 3.00; 95% CI, 1.17-7.69). Controlling for income attenuated that association by about 11% (race OR, 2.71; 95% CI, 1.04-7.06). Education explained about 35% (race OR, 2.39; 95% CI, 0.89-6.42). Adjustment for depression, chronic illness, and education simultaneously resulted in an estimate for race of OR, 2.44; 95% CI, 0.85-7.01.

CONCLUSION

Being black is associated with a sleep disturbance that is accounted for only partially by depression, socioeconomic status, and disease burden. Black primary care patients may benefit from additional screening and monitoring of sleep difficulties.

Sleep duration as a risk factor for incident type 2 diabetes in a multiethnic cohort

PURPOSE

We evaluated the association between sleep duration and type 2 diabetes in a multiethnic cohort, considering insulin sensitivity (S(I)) and secretion (acute insulin response [AIR]), two important diabetes risk factors.

METHODS

Among 900 diabetes-free persons, 146 developed incident type 2 diabetes. At baseline, sleep duration was assessed by self-report and S(I) and AIR by a frequently sampled intravenous glucose tolerance test.

RESULTS

Among non-Hispanic whites and Hispanics, short sleep (<or=7 hours: odds ratio [OR] 2.36; 95% confidence interval [CI] 1.21-3.79 compared to 8 hours) was associated with increased odds of diabetes, adjusting for age, sex, glucose tolerance, clinical site, hypertension, family history of diabetes, smoking, education, and body mass index. Adjustment for S(I) and AIR did not affect short sleep (2.36; 1.11-5.00), but further attenuated the already non-significant association with long sleep (2.15; 0.50-9.30). In African Americans, an opposing pattern was observed, but none of the associations reached statistical significance.

CONCLUSION

Our study supports the role of short sleep as an independent risk factor for type 2 diabetes in whites and Hispanics. While insulin sensitivity and secretion may explain previously reported associations of long sleep duration with diabetes risk, they do not seem to mediate the effects of short sleep on diabetes.

Insomnia symptoms in a multiethnic sample of American women

BACKGROUND

Ethnic disparities in socioeconomic factors, risk markers, and coping styles affect health status. This study examined whether those factors influence insomnia symptoms in a multiethnic sample of urban American women.

METHODS

Women (n = 1440, average age = 59.5 +/- 6.45 years) participating in the study were recruited using a stratified, cluster sampling technique. The sample comprises African Americans (22%), English-speaking Caribbeans (22%), Haitians (22%), Dominicans (12%), Eastern Europeans (11%), and European Americans (11%). Trained staff conducted face-to-face interviews lasting 1.5 hours acquiring demographic, health, and sleep data.

RESULTS

Analysis indicated significant ethnic differences in socioeconomics, risk markers, and health characteristics. The prevalence of insomnia symptoms (defined as either difficulty initiating sleep, difficulty maintaining sleep, or early morning awakening) among African Americans was 71%, English-speaking Caribbeans 34%, Haitians 33%, Dominicans 73%, Eastern Europeans 77%, and European Americans 70%. Hierarchical regression results showed that ethnicity explained 20% of the variance in the insomnia variable. Sociodemographic factors explained 5% of the variance, risk markers explained 5%, medical factors 20%, and coping styles 1%. Goodness-of-fit test indicated the model was reliable [chi-square = 276, p < 0.001], explaining 51% of the variance.

CONCLUSIONS

Findings show interethnic heterogeneity in insomnia symptoms, even among groups previously assumed to be homogeneous. Different factors seemingly influence rates of insomnia symptoms within each ethnic group examined. These findings have direct relevance in the management of sleep problems among women of different ethnic backgrounds. Understanding of ethnic/cultural factors affecting the sleep experience is important in interpreting subjective sleep data.

Sleep duration among black and white Americans: results of the National Health Interview Survey

INTRODUCTION

Epidemiologic studies have shown the importance of habitual sleep duration as an index of health and mortality risks. However, little has been done to ascertain ethnic differences in sleep duration in a national sample. This study compares sleep duration in a sample of black and white participants in the National Health Interview Survey (NHIS).

METHOD

Data were collected from 29,818 Americans (age range 18-85 years) who participated in the 2005 NHIS. The NHIS is a cross-sectional household interview survey that uses a multistage area probability design, thus permitting representative sampling of U.S. households. During face-to-face interviews conducted by trained interviewers from the U.S. Census Bureau, respondents provided demographic data and information about physician-diagnosed chronic conditions, estimated habitual sleep duration and functional capacity, and rated their mood.

RESULTS

Fisher's exact test results indicated that blacks were less likely than whites to report sleeping 7 hours (23% vs. 30%; chi2 = 94, p < 0.0001). Blacks were more likely to experience both short sleep (< or = 5 hours) (12% vs. 8%, chi2 = 44, p < 0.0001) and long sleep (> or = 9 hours) (11% vs. 9%, chi2 = 23, p < 0.0001). Logistic regression analysis, adjusting for differences in sociodemographic factors, depression, functional capacity and medical illnesses, demonstrated that black ethnicity was a significant predictor of extreme sleep duration (Wald = 46, p < 0.0001; OR = 1.35, 95% CI: 1.24-1.47).

DISCUSSION

Independent of several sociodemographic and medical factors, blacks had more prevalent short and long sleep durations, suggesting greater variation in habitual sleep time. Therefore, blacks might be at increased risks of developing medical conditions associated with short and long sleep.

The sleep of African Americans: a comparative review

Researchers have not thoroughly assessed the sleep of African Americans (AAs) despite the recent increased attention to ethnic research. This article reviews the sleep and epidemiological literatures to assess AA sleep. Although the limited data were sometimes inconsistent, they suggest that AAs sleep worse than Caucasian Americans. AAs take longer to fall asleep, report poorer sleep quality, have more light and less deep sleep, and nap more often and longer. AAs have a higher prevalence of sleep-disordered breathing and exhibit more risk factors for poor sleep. These differences are concentrated in young- and middle-age adults. There are no sleep disorders treatment data for AAs. These data support further research into ethnic differences in both normal and disturbed sleep.

Symptoms related to sleep-disordered breathing in white and Hispanic children: the Tucson Children's Assessment of Sleep Apnea Study

STUDY OBJECTIVES

The Tucson Children's Assessment of Sleep Apnea (TuCASA) study is designed to investigate the prevalence and correlates of objectively measured sleep-disordered breathing (SDB) in preadolescent children. This article describes the parental report of sleep symptoms associated with SDB in Hispanic and white children.

DESIGN

A 13-question sleep habits screening questionnaire designed to assess the severity of sleep-related symptoms associated with SDB in children 4 to 11 years of age.

SETTING

Questionnaires were completed by the parents of children attending elementary school in the Tucson Unified School District, Tucson, AZ.

PARTICIPANTS

There were 1,494 questionnaires returned, which comprised a sample of whites (38%), Hispanics (45%), and other races (17%). Of these questionnaires, 1,214 were returned for the children of white (45.8%; 556 children) or Hispanic (54.2%; 658 children) ethnicity only. The primary analysis was completed on these 613 boys (50.5%) and 601 girls (49.5%).

RESULTS

In the total sample of 1,494 children, parents were more likely to report excessive daytime sleepiness (EDS) in female children than in male children (p <.01), however, this association did not achieve significance in the sample of only white and Hispanic children (p <.07). Composite variables for EDS and witnessed apnea (WITAP) show that parents of Hispanic children were more likely to report EDS (p <.01) and WITAP (p <.007). Hispanic children were also more likely to have learning problems (LPs) [p <.03] and to snore frequently (SN) [p <.02] than were white children. There were no significant differences between boys and girls for SN or WITAP. Hispanic boys were more likely to have reports of EDS (p <.02) and LPs (p <.04) than white boys, however, there were no other significant differences in gender or ethnicity in reports of EDS or LPs for white or Hispanic boys and girls. Those children with frequent LPs were significantly more likely to have SN (p <.001), EDS (p <.001), and WITAP (p <.001). A logistic regression model predicting LP resulted in significant adjusted odds ratios (ORs) of 2.4 for SN, 2.5 for EDS, and 2.1 for children aged 8 to 11 years. A similar model for EDS resulted in significant adjusted ORs of 3.2 for SN, 5.7 for WITAP, and 1.6 for female gender. Ethnicity was not significant in either model.

CONCLUSIONS

Hispanic children in the population-based TuCASA study experienced more frequent symptoms associated with SDB, such as SN, EDS, WITAP, and LPs, than did white children. Children with LPs are 2.4 times more likely to have SN, 2.5 times more likely to have EDS, and were 2.1 times more likely to be between the ages of 8 and 11 years. Children with EDS were 3.2 times more likely to have SN, 5.7 times more likely to have WITAP, and were 1.6 times more likely to be a girl.

Sleep Complaints and Visual Impairment Among Older Americans: A Community-Based Study

BACKGROUND

This report describes the associations between sleep complaints and reported visual impairment in an urban community-residing older adult sample.

METHODS

A total of 1118 volunteers from a biracial cohort participated in the study (mean age = 74 +/- 6; mean body mass index = 28 +/- 10). Volunteers were recruited using a stratified, cluster sampling technique. In a standard order, several questionnaires were administered, soliciting information on socioeconomic status, physical health, social support, and emotional experience. The physical health questionnaire included questions on whether or not the volunteer experienced sleep disorder, visual impairment, heart disease, respiratory disease, arthritis, and hypertension. In this report, we present data on the prevalence of reported sleep problems and visual impairment among older adults.

RESULTS

Of the total sample, 9% used sleep medicine, 25% reported difficulty falling asleep, 52% indicated experiencing difficulty maintaining sleep, 28% reported waking up early in the morning, and 12% reported daytime sleep longer than 2 hours. Chi-square results showed greater sleep complaints for volunteers with visual impairment. Consistent with these results, analysis of variance revealed that visually impaired volunteers had a higher index rate of sleep disturbance (F((1, 1110)) = 35.32, p <.0001).

CONCLUSIONS

These data provide evidence that older adults reporting visual impairment are also likely to report sleep complaints. This verifies laboratory findings of an association of ophthalmic diseases with sleep-wake problems and with circadian rhythm abnormalities.

Sleep and sleep habits from childhood to young adulthood over a 10-year period

The aim of this epidemiological study was to utilise a cross-sectional as well as a longitudinal approach to examine sleep habits and how they develop in young people in Iceland. The 668 subjects (1-20 years) who responded to a postal survey in 1985 were followed up 5 and 10 years later. The majority of the variance in bedtime and sleep duration was explained by age, but also to a considerable degree by other factors such as residence, season, and year of survey or interaction of these factors. Natural phenomena, such as the diminution of total sleep duration in the first years of life and the tendency for longer sleep on weekends compared to weekdays were confirmed. The lengthening of sleep on weekends was first significant at the age of 9 and was greater among adolescents than young adults. The incidence of daytime sleepiness increased in adolescence, as did napping, at which time their nocturnal sleep time significantly decreased. Over a period of 10 years, a significant shift to earlier wake-up times occurred in children up to 15 years of age, which resulted in a shortened total sleep time. The idea that individual sleep duration is an inherent parameter is supported by the high positive correlation of total sleep time across a 10-year period (r=.73). The present data confirm that Icelandic adolescents (aged 11, 13, and 15) have delayed bedtimes and shorter nocturnal sleep compared to European peers.

Ethnicity, Sleep Hygiene Knowledge, and Sleep Hygiene Practices

We tested the mean differences in scores on Sleep Hygiene Knowledge and on Sleep Hygiene Practices among four ethnic groups of university students (N = 963). We computed significant main effects for ethnicity for both of these variables. Primarily the results reflect that the Euro-American students scored significantly higher on both scales than each of the other three groups.