Independent and joint associations of race/ethnicity and educational attainment with sleep-related symptoms in a population-based US sample.
Independent and joint associations of race/ethnicity and educational attainment with sleep-related symptoms in a population-based US sample.
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DOI：
10.1016/j.ypmed.2015.05.008
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发表时间：
2015-08
影响因子：
5.1
通讯作者：
Croft JB
中科院分区：
文献类型：
--
作者：
Cunningham TJ;Ford ES;Chapman DP;Liu Y;Croft JB
先前的研究已经记录了教育程度和种族/民族分别在短时间和长时间睡眠、白天过度嗜睡和失眠方面的差异。我们在一个种族/民族多样化的样本中，用更广泛的睡眠指标研究了这些因素的独立和交互作用。我们分析了来自33，865名年龄≥18岁的成年人的2012年全国健康访谈调查数据。睡眠相关疾病包括睡眠时间短（≤6 h）、睡眠时间长（≥9 h）、疲劳>3天、白天过度嗜睡和失眠。采用卡方检验和对数线性回归进行双变量分析。总的年龄调整后的患病率为29.1%，睡眠时间短，8.5%的睡眠时间长，15.1%的疲劳，12.6%的白天过度嗜睡，18.8%的失眠。教育程度和种族/民族独立相关的五个睡眠相关症状。在白人中，大多数睡眠指标的可能性随着教育程度的下降而增加;其他种族/民族的关系各不相同。对于短睡眠时间，与白人相比，非洲裔美国人（p < 0.0001），西班牙裔美国人（p <0.0001）和亚洲人（p = 0.0233）的教育程度-种族/民族相互作用效应显著。对于长时间睡眠，只有西班牙裔人的相互作用是显着的（p = 0.0003）。我们的研究结果证明了同时检查教育程度和种族/民族的重要性，以更充分地了解睡眠健康的差异。需要更多地了解社会人口因素与睡眠健康之间的联系机制，以确定提高教育程度的政策和计划是否也可以减少日益多样化的人口中的这些差异。
Prior studies have documented disparities in short and long sleep duration, excessive daytime sleepiness, and insomnia by educational attainment and race/ethnicity separately. We examined both independent and interactive effects of these factors with a broader range of sleep indicators in a racially/ethnically diverse sample. We analyzed 2012 National Health Interview Survey data from 33,865 adults aged ≥18 years. Sleep-related symptomatology included short sleep duration (≤6 h), long sleep duration (≥9 h), fatigue >3 days, excessive daytime sleepiness, and insomnia. Bivariate analyses with chi-square tests and log-linear regression were performed. The overall age-adjusted prevalence was 29.1% for short sleep duration, 8.5% for long sleep duration, 15.1% for fatigue, 12.6% for excessive daytime sleepiness, and 18.8% for insomnia. Educational attainment and race/ethnicity were independently related to the five sleep-related symptoms. Among Whites, the likelihood of most sleep indicators increased as educational attainment decreased; relationships varied for the other racial/ethnic groups. For short sleep duration, the educational attainment-by-race/ethnicity interaction effect was significant for African Americans (p < 0.0001), Hispanics (p < 0.0001), and Asians (p = 0.0233) compared to Whites. For long sleep duration, the interaction was significant for Hispanics only (p = 0.0003). Our results demonstrate the importance of examining both educational attainment and race/ethnicity simultaneously to more fully understand disparities in sleep health. Increased understanding of the mechanisms linking sociodemographic factors to sleep health is needed to determine whether policies and programs to increase educational attainment may also reduce these disparities within an increasingly diverse population.