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Cited by 922Sleep and related disordersObstructive Sleep Apnea ResearchSleep and Work-Related Fatigue

Racial/Ethnic Differences in Sleep Disturbances: The Multi-Ethnic Study of Atherosclerosis (MESA)

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Chen, Xiaoli, Wang, Rui, Zee, Phyllis, Lutsey, Pamela L., Javaheri, Sogol, Alcántara, Carmela, Jackson, Chandra L., Williams, Michelle A. +1 more·2015·SLEEP
DOI 10.5665/sleep.4732PMC PMC4434554
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Abstract

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 self-reported 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 non-obese 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.

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  • Obstructive sleep apnea is widely underdiagnosed; 86% to 95% of individuals found in population surveys with clinically significant obstructive sleep apnea report no prior diagnosis.

    “OSA is widely underdiagnosed; 86% to 95% of individuals found in population surveys with clinically significant OSA report no prior OSA diagnosis.5”

    From Obstructive Sleep Apnea and Cardiovascular Disease: A Scientific Statement From the American Heart Association (2021) · cites this paper as [5]

    The Sleep Disordered Breathing section reports that 84%–93% of MESA participants with moderately or severely elevated apnea-hypopnea index levels were undiagnosed, supporting the point that sleep apnea is substantially underdiagnosed. It does not report the claimed 86%–95% range, and that estimate comes from the MESA cohort rather than population surveys generally. Page numbers are unavailable in our copy. (LLM, conf=0.90)

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Authors
Chen, X., Wang, R., Zee, P., Lutsey, P. L., Javaheri, S., Alcántara, C., Jackson, C. L., Williams, M. A., & Redline, S.
Affiliations
  • Harvard University (US)
  • Brigham and Women's Hospital (US)
  • Northwestern University (US)
  • University of Minnesota (US)
  • Columbia University Irving Medical Center (US)
Corresponding author
Chen, Xiaoli
ORCID
Venue
SLEEP
Publisher
Oxford University Press (OUP)
Published
2015-06-01
Volume
38
Issue
6
Pages
877-88
ISSN
  • 0161-8105 (ISSN-L)
  • 1550-9109
DOI
10.5665/sleep.4732
PMC
PMC4434554
OpenAlex
W1937674079
Semantic Scholar
fa71da1fe92b769a3b5f702b98a0bb300e3b10b4
Cited by
922
References
58
Citations by year
2026: 55 · 2025: 121 · 2024: 129 · 2023: 126 · 2022: 139 · 2021: 83 · 2020: 71 · 2019: 65 · 2018: 44 · 2017: 46 · 2016: 37 · 2015: 5
FWCI
65.66
Type
journal article
Language
en
Open access
Locations
  • SLEEP (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • Columbia Academic Commons (Columbia University)
Funders
  • National Institutes of Health (n01hc095169-003, 5r01hl115941-03, UL1TR000170)
  • National Heart, Lung, and Blood Institute (R01HL113338, R21HL108226, R01HL098433, R01HL109493, 3R01HL115941-01S1, R01HL110068, U34HL105277, 1R01HL083075-01, N01 HC95169)
  • National Institute of Neurological Disorders and Stroke (P20NS076965)
  • National Center for Advancing Translational Sciences
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
Keywords
sleep disorders, racial and ethnic differences, sleep apnea, sleep-disordered breathing, short sleep duration, poor sleep quality, daytime sleepiness, insomnia, undiagnosed sleep apnea, health disparities, obesity, middle-aged and older adults, Multi-Ethnic Study of Atherosclerosis
MeSH terms
Aged, Aged, 80 and over, Cross-Sectional Studies, Ethnicity, Female, Hispanic or Latino, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Obesity, Sleep Apnea Syndromes, Sleep Wake Disorders, Sleep Stages, United States, Cohort Studies, Prevalence, Odds Ratio, Polysomnography, White People, Asian People, Racial Groups, Atherosclerosis, Actigraphy, Self Report

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