RACIAL/ETHNIC DIFFERENCES IN SLEEP DISTURBANCES Racial/Ethnic Differences in Sleep Disturbances: The Multi-Ethnic Study of Atherosclerosis (MESA)

877 Race/Ethnicity and Sleep Disturbances in US Adults—Chen et al. INTRODUCTION The prevalence of sleep disordered breathing (SDB), short sleep duration, and insomnia has increased substantially over the past two decades.1,2 Epidemiologic studies have linked sleep disturbances to adverse health outcomes including obesity,3 hypertension,3 cardiovascular disease (CVD),3,4 premature mortality,5,6 impaired quality of life,7 and economic burden.8 An understanding of the distributions of sleep disturbances across sociodemographic groups may inform public health efforts aimed at reducing health and economic burdens of sleep disturbances.9 Previous research has indicated that SDB and other sleep disturbances are common among men and older individuals, and may vary across racial/ethnic groups.2,9–14 Few populationbased studies, however, have quantified differences in sleep Objectives: 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.