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Racial/Ethnic Differences in Sleep Disturbances: The Multi-Ethnic Study of Atherosclerosis (MESA)
Open accessAbstract
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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“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]
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Metadata
- 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
- 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
- bronze
- doi.org
- 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 (medical) › 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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