Valerie Newsome

Differences in short and long sleep durations between blacks and whites attributed to emotional distress: analysis of the National Health Interview Survey in the United States

Objectives: The current study examined the role of emotional distress in explaining racial/ethnic differences in unhealthy sleep duration. Design: Data from the 2004‐2013 National Health Interview Survey were analyzed using SPSS 20. Setting: Data were collected through personal household interviews in the United States. Participants: Of the total 261,686 participants (age ≥ 18 years), 17.0% were black, 83.0% were white, and the mean age was 48 years (SE = 0.04). Measurements: To ascertain total sleep duration, participants were asked, “How many hours of sleep do you get on average in a 24‐hour period?” Sleep duration was coded as short sleep (<7 hours), average sleep (7‐8 hours), or long sleep (>8 hours). Emotional distress—feeling sad, nervous, restless, hopeless, worthless, and burdened over a 30‐day period—was measured using Kessler‐6, a 6‐item screening scale. Results: Of the participants reporting significant emotional distress (4.0% black, 3.5% white), χ2 analyses revealed that a higher percentage of blacks, compared with whites, reported unhealthy sleep durations. Relative to Whites, Blacks had increased prevalence of short sleep (prevalence ratio = 1.32, P < .001) or long sleep (odds ratio =1.189, P < .001). The interaction between race/ethnicity and emotional distress was significantly associated with short (prevalence ratio = 0.99, P < .001) and long sleep (odds ratio = 0.98, P < .001) durations. Conclusions: Individuals of the black race/ethnicity or those reporting greater levels of emotional distress are more likely to report short or long sleep duration. Emotional distress might partially explain racial/ethnic differences in unhealthy sleep duration between blacks and whites.

Resistant Hypertension and Sleep Duration among Blacks with Metabolic Syndrome MetSO.

INTRODUCTION Resistant hypertension (RHTN) is an important condition affecting 29% of the hypertensive population in the U.S., especially among blacks. Sleep disturbances, like obstructive sleep apnea, insomnia, and short sleep duration, are increasingly recognized as underlying modifiable factors for RHTN. We evaluated associations of RHTN with short sleep duration among blacks with metabolic syndrome. METHODS Data from the Metabolic Syndrome Outcome Study (MetSO), a NIH-funded cohort study characterizing metabolic syndrome (MetS) among blacks were analyzed. MetS was defined according to criteria from the Adult Treatment Panel (ATP III). RHTN was defined according to guidelines from the American Heart Association. Short sleep was defined as self-reported sleep duration <7 hrs experienced during a 24-hour period. RESULTS Analysis was based on 1,035 patients (mean age: 62±14years; female: 69.2%). Of the sample, 90.4% were overweight /obese; 61.4% had diabetes; 74.8% had dyslipidemia; 30.2% had a history of heart disease; and 48% were at high risk for obstructive sleep apnea. Overall, 92.6% reported physician-diagnosed hypertension (HTN) and 20.8% met criteria for RHTN. Analyses showed those with RHTN were more likely to be short sleepers (26.8% vs. 14.9%, p< 0.001). Based on logistic regression analysis, adjusting for effects of age, sex, and medical comorbidities, patients with metabolic syndrome and RHTN had increased odds of being short sleepers (OR = 1.95, 95% CI: 1.28-2.97, p = 0.002). CONCLUSION Among blacks with metabolic syndrome, patients meeting criteria for resistant hypertension showed a twofold greater likelihood of being short sleepers, prompting the need for sleep screening in this vulnerable population.

Moderating effects of sleep duration on diabetes risk among cancer survivors: analysis of the National Health Interview Survey in the USA

Background Growing evidence suggests that cancer and diabetes may share common risk factors such as age, race/ethnicity, obesity, insulin resistance, sedentary lifestyle, smoking, and alcohol consumption. However, little is known about how habitual sleep duration (a known cardiometabolic risk factor) may affect the relationship between cancer and diabetes. The aim of this study was to investigate whether sleep duration moderated the relationship between history of cancer and diabetes. Methods Data were extracted from the National Health Interview Survey dataset from 2004 to 2013 containing demographics, chronic diseases, and sleep duration (N=236,406). Data were analyzed to assess the moderating effect of short and long sleep durations on cancer and diabetes mellitus. Results Our findings indicate that short sleep (odds ratio [OR] =1.07, 95% CI =1.03–1.11, P<0.001) and long sleep (OR =1.32, 95% CI =1.26–1.39, P<0.001) were associated with diabetes mellitus in fully adjusted models. However, only long sleep duration significantly moderated the relationship between cancer and diabetes (OR =0.88, 95% CI =0.78–0.98, P<0.05). Conclusion Our findings indicate that for cancer survivors, short sleep was associated with higher self-reported diabetes and long sleep duration may act as a buffer against diabetes mellitus, as the likelihood of self-reported diabetes was lower among cancer survivors who reported long sleep duration. Impact Findings from the current study have clinical and public health implications. Clinically, comprehensive sleep assessments and sleep interventions to improve sleep are needed for cancer survivors who have comorbid diabetes. Our findings can also spur public health reform to make sleep an important component of standard cancer survivorship care, as it reduces other chronic disease like diabetes.

Educated and At-Risk: How the Shortage of Available Partners Influences HIV Risk for College-Educated African-American Women

BACKGROUND African-Americans have the greatest gender-ratio imbalance compared to other racial groups in the United States. This has been associated with higher rates of concurrent sexual partnerships, increasing risk of HIV infection. College-educated African-American women are of particular interest as they are not often represented in studies on HIV prevention, while their dating and sexual negotiation patterns may differ from those of their lower-educated and lower-income counterparts more often the subject of study in HIV research among African-Americans. METHOD In this qualitative study, we investigate: a) how the gender-ratio imbalance is perceived by college-educated African-American women, b) how they feel limited partner availability impacts heterosexual relationships in the African-American community, and c) the influence this has on their sexual decision making and HIV protective behaviors. RESULTS Four major themes emerged- Limited pool of available male partners, Pressure to get married, Feelings of competition among women for male partners, and Mens negotiating power in relationships. CONCLUSIONS Using the PEN-3 Cultural Model, we discuss how this information may be used to develop interventions for this group of women designed to address their more specific barriers to HIV risk reduction.

Place of birth and sleep duration: Analysis of the national health interview survey (NHIS)

While sleep disturbance has been related to a number of negative health outcomes, few studies have examined the relationship between place of birth and sleep duration among individuals living in the US. Data for 416,152 adult participants in the 2000–2013 National Health Interview Survey (NHIS), who provided self-reported hours of sleep and place of birth were examined. Associations were explored between healthy sleep (7–8 h), referenced to unhealthy sleep (<7 or >8 h), and place of birth using multivariate logistic regression analysis. The mean age of the sample was 47.4 ± 0.03 years; 56% were female. Of the respondents, 61.5% reported experiencing healthy sleep, 81.5% reported being born in the US and 18.5% were foreign-born adults. Descriptive statistics revealed that Indian Subcontinent-born respondents (71.7%) were more likely to report healthy sleep compared to US-born respondents (OR = 1.53, 95% CI = 1.37–1.71, p < 0.001), whereas African-born respondents (43.5%) were least likely to report healthy sleep (OR = 0.78, 95% CI = 0.70–0.87, p < 0.001). These findings suggest that place of birth should be considered in the assessment of risk factors for unhealthy sleep.