Associations of Self-Reported Sleep Duration and Sleep Difficulties with Cardiometabolic Risk Factors among U.S.-born and Foreign-born Black Adults in the United States: NHANES 2005-2016 Público

Abstract

Self-reported sleep duration and poor sleep quality are understudied determinants of cardiometabolic (CMB) health, particularly among Black populations, who are most-at-risk. We conducted a cross-sectional analysis among 5,589 Non-Hispanic Black adults (U.S.-born: N = 4974, Foreign-born: N = 615) using National Health and Nutritional Examination Survey data from 2005 to 2016. Poisson regression models with robust variance estimators were fit to estimate the association between self-reported sleep duration and sleep difficulties with CMB risk factors (overweight, obesity, hypertension, diabetes) with adjustment for sociodemographic and health behaviors. Adjusted ordinal logistic regression models were fit to estimate the associations between sleep measures and CMB comorbidity. Effect modification by nativity and length of U.S. residence (Foreign-born adults only) was assessed. Participants’ mean age was 44.1 years, 45.7% were males, 49% were short sleepers, 8.8% were long sleepers, 28.6% were overweight, 46.6% were obese, 55.3% were hypertensive, and 15.7% were diabetic. Longer sleep and long sleep were associated with lower prevalence of obesity, PR: 0.97, 95% CI: 0.96, 0.99 and PR: 0.87, 95% CI: 0.80, 0.95, respectively. Short sleepers were more likely to be overweight (PR: 1.09, 95% CI: 1.03, 1.16) and obese (PR: 1.06, 95% CI: 1.01, 1.10). Among U.S.-born adults, long sleep was associated with lower prevalence of obesity (PR: 0.88, 95% CI: 0.80, 0.97); sleep difficulties were associated with a higher prevalence of hypertension (PR: 1.07, 95% CI: 1.01, 1.14) and CMB comorbidity (PR: 1.17, 95% CI: 1.02, 1.35). Among Foreign-born adults, longer sleep was associated with a lower prevalence of hypertension (PR: 0.94, 95% CI: 0.89, 0.99) and CMB comorbidity (PR: 0.87, 95% CI: 0.78, 0.97); short sleep was associated with a higher prevalence of obesity (PR: 1.30, 95% CI: 1.04, 1.63). Among recent Black immigrants (<10 years in the U.S.), short sleepers were more likely to be hypertensive (PR: 1.75, 95% CI: 1.13, 2.72). Short sleep was associated with being overweight and obese among Black adults. Associations between sleep duration or difficulties and CMB risk factors varied by nativity. As a heterogenous group, examining within race differences allows for development of specific sleep health interventions to address these disparities.

Table of Contents

Introduction........................................................................................................................... 1

Methods................................................................................................................................. 9

Results................................................................................................................................... 14

Discussion............................................................................................................................. 21

References............................................................................................................................. 35

Tables.................................................................................................................................... 41

Figures................................................................................................................................... 45

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology
Palavra-chave	Obesity Black health Sleep difficulties Black immigrant health Cardiometabolic risk factors Sleep Cardiometabolic health Sleep duration Nativity Hypertension Diabetes
Committee Chair / Thesis Advisor	Dayna A. Johnson, PhD, MPH, MSW, MS, Emory University

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