The effects of age, sex, ethnicity, and sleep-disordered breathing on sleep architecture
Abstract
BACKGROUND: Polysomnography is used to assess sleep quality and to gauge the functional effect of sleep disorders. Few population-based data are available to estimate the variation in sleep architecture across the population and the extent to which sleep-disordered breathing (SDB), a common health condition, contributes to poor sleep independent of other factors. The objective of this study was to describe the population variability in sleep quality and to quantify the independent associations with SDB. METHODS: Cross-sectional analyses were performed on data from 2685 participants, aged 37 to 92 years, in a community-based multicenter cohort study. Dependent measures included the percentage time in each sleep stage, the arousal index, and sleep efficiency. Independent measures were age, sex, ethnicity, comorbidity status, and the respiratory disturbance index. RESULTS: Lighter sleep was found in men relative to women and in American Indians and blacks relative to other ethnic groups. Increasing age was associated with impaired sleep in men, with less consistent associations in women. Notably, women had, on average, 106% more slow wave sleep. Sleep-disordered breathing was associated with poorer sleep; however, these associations were generally smaller than associations with sex, ethnicity, and age. Current smokers had lighter sleep than ex-smokers or never smokers. Obesity had little effect on sleep. CONCLUSIONS: Sleep architecture varies with sex, age, ethnicity, and SDB. Individual assessment of the effect of SDB on sleep quality needs to account for other host characteristics. Men, but not women, show evidence of poorer sleep with aging, suggesting important sex differences in sleep physiology.
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Blacks/African-Americans obtained less Slow Wave Sleep than Non-Hispanic Whites.
“Blacks/African-Americans also obtained less Slow Wave Sleep. Other studies have also found that Blacks/African-Americans obtained less Slow Wave Sleep(215-219)”
From Sleep: important considerations for the prevention of cardiovascular disease (2016) · cites this paper as [218]
Studies using polysomnography consistently observed lower amounts of slow wave sleep and reduced sleep efficiency among African Americans compared to non-Hispanic whites.
“several studies that used polysomnography (PSG) consistently observed lower amounts of slow wave sleep and reduced sleep efficiency among African Americans compared to non-Hispanic whites [13–16]”
From Association between sleep deficiency and cardiometabolic disease: implications for health disparities (2016) · cites this paper as [14]
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- Authors
- Redline, S., Kirchner, H. L., Quan, S. F., Gottlieb, D. J., Kapur, V., & Newman, A.
- Affiliations
- Rainbow Babies & Children's Hospital (US)
- Case Western Reserve University (US)
- University of Arizona (US)
- Boston University (US)
- University of Washington (US)
- University of Pittsburgh (US)
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2004-02-23
- Volume
- 164
- Issue
- 4
- Pages
- 406
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W2139496586
- Cited by
- 732
- References
- 45
- Citations by year
- 2026: 26 · 2025: 45 · 2024: 37 · 2023: 40 · 2022: 31 · 2021: 51 · 2020: 51 · 2019: 46 · 2018: 27 · 2017: 35 · 2016: 42 · 2015: 26 · 2014: 35 · 2013: 28 · 2012: 36
- FWCI
- 9.74
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5u01hl053940-05, 5u01hl053934-14)
- National Heart, Lung, and Blood Institute (U01 HL 53940, U01HL053941, U01HL053938, U01 HL53934, U01HL053937, U01HL053931, U01HL063463)
- Topics
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Keywords
- sleep architecture, sleep-disordered breathing, sex differences, aging, ethnicity, slow-wave sleep, sleep efficiency, arousal index, respiratory disturbance index, smoking, obesity, sleep quality, comorbidities
- MeSH terms
- Adult, Age Factors, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Sex Factors, Sleep, Sleep Apnea Syndromes, Comorbidity, Body Mass Index, Multivariate Analysis
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