Sleep and health disparities among Asian Americans: roles of stressors and protective factors

项目总结 与白人或西班牙裔美国人相比，亚裔美国人有更多的睡眠不足。然而，大多数关于 睡眠差距主要集中在非裔美国人和拉美裔美国人身上，而对亚洲人的研究仍然很少。 我们对中国人、韩国人和越南裔美国人的初步研究发现，文化适应压力是 睡眠时间与睡眠时间呈负相关，与睡眠障碍和睡眠呼吸暂停风险呈正相关。 重要的是，新冠肺炎已经对包括睡眠在内的健康造成了不利影响，少数族裔人口 受到不成比例的影响。此外，针对亚洲人的仇恨言论和种族主义攻击一直在增加 据报道，这导致这一人群的精神和情感损失增加。初步研究的结果 睡眠时间与糖尿病呈负相关，睡眠呼吸暂停与糖尿病呈正相关 与高血压和肥胖症有关。 这项创新的纵向研究的首要目标是了解：(1)睡眠差异的机制 与移民压力源和保护因素有关；以及(2)睡眠不平等对健康的影响 结果，在社区居住的中国人、韩国人和越南成年人的样本中(n=750)。本研究 包括新冠肺炎等多项创新措施对反亚裔种族主义产生的不利影响 新冠肺炎和多维睡眠健康；使用干血斑；有目的地抽取3名亚洲人 亚群；将族裔飞地视为保护因素。 在5年的项目期内，调查人员将收集和分析两波数据，以便：(1) 确定移民应激源(例如，文化适应压力、心理压力)之间的纵向联系 和新冠肺炎的不利影响、反亚裔种族主义和邻里劣势)和睡眠健康(多 睡眠健康和睡眠障碍的维度评估)；(2)评估潜力的调节效果 保护性因素(例如，社会支持、宗教参与、种族飞地和邻里社会凝聚力) 移民应激源与睡眠健康的相关性研究(3)纵向相关性检验 睡眠健康和心脏代谢风险指标之间的关系；以及(4)测试睡眠的特定维度 健康将在移民压力源和健康结果之间的联系中起中介作用。 这将是第一批纵向研究之一，以探讨睡眠差异的机制与 移民压力源和睡眠差距对亚洲人健康结局的影响 研究不足的少数群体，他们的睡眠结果比其他群体更差。这项研究是 适时考虑到亚洲人在美国的快速增长，以及目前亚洲人和 移民，包括新冠肺炎。这项创新研究将阐明这一未被研究的群体的健康问题，并 确定将作为干预目标的可修改因素，以减少亚洲人的睡眠差距。

PROJECT SUMMARY Asian Americans have more sleep deficiencies compared to Whites or Hispanics. However, most studies of sleep disparities have focused on African Americans and Hispanics, and research on Asians remains scarce. Our preliminary study among Chinese, Korean, and Vietnamese Americans found that acculturative stress was inversely associated with sleep duration and positively associated with sleep disturbance and risk of sleep apnea. Importantly, COVID-19 has adversely affected health, including sleep, with minority populations being disproportionately affected. Additionally, increasing hate speech and racist attacks against Asians have been reported, leading to increased mental and emotional toll in this population. Findings from the preliminary study also demonstrated that sleep duration was inversely associated with diabetes, and sleep apnea was positively associated with hypertension and obesity. The overarching goal of this innovative longitudinal study is to understand: (1) mechanisms of sleep disparities in relation to immigrant stressors and protective factors; and (2) consequences of sleep disparities on health outcomes, in a sample of community-dwelling Chinese, Korean, and Vietnamese adults (n=750). This study includes several innovations such as novel measures on anti-Asian racism due to COVID-19, the adverse impact of COVID-19, and multi-dimensional sleep health; use of dried blood spots; purposive sampling of 3 Asian subgroups; and considering ethnic enclaves as a protective factor. Over the 5-year project period, the investigators will collect and analyze two waves of data in order to: (1) Determine the longitudinal association between immigrant stressors (e.g., acculturative stress, psychological stress and adverse impact of COVID-19, anti-Asian racism, and neighborhood disadvantage) and sleep health (a multi- dimensional assessment of sleep health and disturbance); (2) Evaluate the moderating effect of potential protective factors (e.g., social support, religious involvement, ethnic enclaves, and neighborhood social cohesion) on the associations between immigrant stressors and sleep health; (3) Examine the longitudinal association between sleep health and markers of cardiometabolic risk; and (4) Test whether specific dimensions of sleep health will mediate the association between immigrant stressors and health outcomes. This will be one of the first longitudinal studies to investigate mechanisms of sleep disparities in relation to immigrant stressors and the consequences of sleep disparities on health outcomes among Asians, an understudied minority population which displays poorer sleep outcomes relative to other groups. This study is timely considering the rapid growth of Asians in the U.S., and the current hostile environment for Asians and immigrants, including COVID-19. This innovative study will elucidate health issues of this understudied group and identify modifiable factors that will serve as targets for intervention to reduce sleep disparities among Asians.