Sleep Health and Serious Psychological Distress: A Nationally Representative Study of the United States among White, Black, and Hispanic/Latinx Adults

Samuel J Goldstein; Symielle A Gaston; John A McGrath; Chandra L Jackson

doi:10.2147/NSS.S268087

Sleep Health and Serious Psychological Distress: A Nationally Representative Study of the United States among White, Black, and Hispanic/Latinx Adults

Nat Sci Sleep. 2020 Dec 2:12:1091-1104. doi: 10.2147/NSS.S268087. eCollection 2020.

Authors

Samuel J Goldstein¹, Symielle A Gaston², John A McGrath³, Chandra L Jackson^{2

4}

Affiliations

¹ The University of North Carolina at Chapel Hill, Department of Environmental Sciences and Engineering, Chapel Hill, NC, USA.
² Department of Health and Human Services, Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA.
³ Social & Scientific Systems, Inc, Durham, NC, USA.
⁴ Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.

Abstract

Purpose: Prior studies investigating the relationship between sleep and serious psychological distress (SPD) have lacked racial/ethnic diversity and generalizability. We investigated associations between sleep and SPD among a large, nationally representative, and racially/ethnically diverse sample of US adults.

Methods: We pooled cross-sectional data from the 2004 to 2017 National Health Interview Survey. Participants self-reported sleep duration and sleep disturbances (eg, trouble falling and staying asleep). SPD was defined as a Kessler Psychological Distress Scale (K6) score ≥13. Adjusting for sociodemographic, health behavior, and clinical characteristics, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) of SPD for each sleep characteristic, overall and by race/ethnicity.

Results: Among 316,840 participants, the mean age ± standard error was 46.9 ± 0.1 years, 52% were women, 75% were non-Hispanic (NH)-White, 16% NH-Black, and 9% Hispanic/Latinx. The prevalence of SPD was 3.4% for NH-Whites, 4.1% for NH-Blacks, and 4.5% for Hispanics/Latinxs. Participants with <7 hours versus 7-9 hours of sleep duration were more likely to have SPD, and the magnitude of the association was strongest among NH-Black participants (PR_NH-Blacks=3.50 [95% CI: 2.97-4.13], PR _{Hispanics/Latinx}=2.95 [2.42-3.61], and PR_NH-Whites=2.66 [2.44-2.89]). Positive associations between sleep disturbances and SPD were generally stronger among NH-Black and Hispanic/Latinx compared to NH-White adults.

Conclusion: Poor sleep health was positively associated with SPD, and the magnitude of the association was generally stronger among racial/ethnic minorities. Future investigations should prospectively focus on the determinants and health consequences of SPD attributable to objectively measured sleep across racial/ethnic groups.

Keywords: continental population groups; health status disparities; psychological stress; race factors; sleep; sleep initiation and maintenance disorders.

Grants and funding

This work was funded by the Intramural Program at the NIH, NIEHS (Z1AES103325-01) and the NIEHS Scholars Connect Program.