Sleep Disordered Breathing, Insomnia Symptoms, and Sleep Quality in a Clinical Cohort of US Hispanics in South Florida (original) (raw)
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Overview of Sleep Disorders Among Latinos in the United States
Hispanic Health Care International, 2010
L atinos ("Hispanic" suggests direct lineage from Spain; "Latino" has become the preferred ethnic descriptor for persons from Latin American countries who have Spanish ancestry; this article will use "Latinos") are the fastest growing minority group in the United States and represent at minimum 20 different Latin American countries and the Caribbean; 40% were born outside the United States (U.S. Census Bureau, 2004). In 1998, there were 30 million persons of Latino heritage representing 11% of the population. By the year 2050, it is estimated that Latinos will number 97 million and constitute 25% of the U.S. population; Mexican Americans represent the largest subgroup, comprising 64.3% of the Latino population (U.S. Census Bureau, 1996). As of 2007, U.S. census estimates indicated the Latino population reached 45.5 million or 15% of the total U.S. population of 301.6 million (U.S. Census Bureau, 2007). Therefore, factors such as sleep quality and sleep disorders that may impact the health of this rapidly growing segment of the U.S. population are important now, and will be increasingly meaningful in the future. The purpose of this article is to (1) describe the associations between sleep disorders and comorbid conditions extant in the literature, (2) provide an overview of the health disparities of Latinos, including language barriers,
Sleep health in US Hispanic population
Sleep, 2010
The importance of sleep on health has only been recently recognized, and the general public and the medical community are not yet fully knowledgeable about this issue. The great majority of sleep research has been performed in whites of European descent and to a lesser extent in African Americans, making generalization of the findings to other ethnic and racial groups difficult. Very little sleep research has been done in U.S. Hispanics. However, based on the available literature and the high prevalence of risk factors in Hispanics, such as obesity, diabetes, living in the inner city, and use of alcohol, the prevalence of such important sleep disorders such as obstructive sleep apnea and sleep habits such as poor sleep hygiene are suspected to be high. There is also some evidence that acculturation to the U.S. life style may lead to worse sleep habits in Hispanics, including fewer hours of sleep. Two current large NIH sponsored studies of sleep in U.S. Hispanics promise to significantly add to the literature on various sleep disorders such as sleep disordered breathing, insomnia, restless legs syndrome, periodic limb movement disorder, and sleep habits such as short sleep duration and sleep hygiene.Citation:Loredo JS; Soler X; Bardwell W; Ancoli-Israel S; Dimsdale JE; Palinkas LA. Sleep health in U.S. Hispanic population. SLEEP 2010;33(7):962-967.
Open Journal of Respiratory Diseases, 2013
Objectives: To investigate differences in sleep quality between Hispanics of Mexican descent (HMD) and Non-Hispanic Whites (NHW) and evaluate the effect of acculturation to the US lifestyle in sleep health. We hypothesize that the detrimental effect of acculturation on health outcomes will impact sleep quality among HMD. Design: We performed a population-based random digit dialing telephone survey to determine sleep quality in HMD and NHW. We collected from 3667 subjects, demographics, previous diagnosis of depression or anxiety, past treatment for sleep disorders, the Pittsburgh Sleep Quality Index (PSQI) and the Short Acculturation Scale for Hispanics. Results: The prevalence of poor sleep quality (PSQI > 5) was 64.4% for HMD and 64.3% for NHW (p = 0.93). A prior diagnosis of depression or anxiety was an independent predictor of poor sleep quality in both groups (OR 3.4 and 2.7 for HMD and NHW. Ethnicity was not a predictor of poor sleep quality in HMD or NHW. Acculturation was not a predictor of poor sleep quality in HMD. However, highly acculturated young HMD males had significantly more prevalence of poor sleep quality compared to NHW (64.8% vs. 49.8%, p < 0.001). Conclusion: The absence of sleep quality differences in a large sample of HMD and NHW living in San Diego County is contrary to current data of having poorer sleep quality among Latinos. We found that neither ethnicity nor acculturation were predictors of poor sleep quality in HMD. However, we demonstrated a highly prevalent poor sleep quality among the two ethnic groups. The finding of significantly lower sleep quality in young highly acculturated HMD men may represent the heterogeneity of ethnicity related to sleep. Programs to improve sleep quality in subjects with depression and/or anxiety, and in young highly-acculturated HMD seems warranted.
Actigraphic Sleep Patterns of U.S. Hispanics: The Hispanic Community Health Study/Study of Latinos
Sleep, 2016
Study objective: To assess the extent to which objective sleep patterns vary among U.S. Hispanics/Latinos. Methods: We assessed objective sleep patterns in 2087 participants of the Hispanic Community Health Study/Study of Latinos from 6 Hispanic/Latino subgroups aged 18-64 years who underwent 7 days of wrist actigraphy. Results: The age-and sex-standardized mean (SE) sleep duration was 6.82 (0.05), 6.72 (0.07), 6.61 (0.07), 6.59 (0.06), 6.57 (0.10), and 6.44 (0.09) hr among individuals of Mexican, Cuban, Dominican, Central American, Puerto Rican, and South American heritage, respectively. Sleep maintenance efficiency ranged from 89.2 (0.2)% in Mexicans to 86.5 (0.4)% in Puerto Ricans, while the sleep fragmentation index ranged from 19.7 (0.3)% in Mexicans to 24.2 (0.7)% in Puerto Ricans. In multivariable models adjusted for age, sex, season, socioeconomic status, lifestyle habits, and comorbidities, these differences persisted. Conclusions: There are important differences in actigraphically measured sleep across U.S. Hispanic/Latino heritages. Individuals of Mexican heritage have longer and more consolidated sleep, while those of Puerto Rican heritage have shorter and more fragmented sleep. These differences may have clinically important effects on health outcomes.
Factors associated with sleep disturbance in women of Mexican descent
Journal of Advanced Nursing, 2012
Aims. The aims were to identify the most useful parameters of acculturation in relation to self-reported sleep disturbance and describe risk factors for sleep disturbance in women of Mexican descent. Background. Little is known about acculturation as a factor for poor sleep in the context of other personal factors such as income or sense of resilience or mastery for Latinas in the United States. Design. This study was a secondary analysis of cross sectional survey data. Methods. Personal factors were incorporated into a modification of the Conceptual Framework of Impaired Sleep to guide our secondary analysis of self-reported sleep disturbance. Data were collected from a convenience sample of 312 women of Mexican descent of childbearing age (21-40 years) located in an urban California community were collected and previously analysed in relation to depressive symptoms and post-traumatic stress disorder. The General Sleep Disturbance Scale (in English and Spanish) was used to assess sleep disturbance. Data was collected in 1998 from September through December. Results. Early socialization to the United States during childhood was the most useful acculturation parameter for understanding self-reported sleep disturbance in this sample. In a multivariate regression analysis, three factors (higher acculturation, lower income and higher depressive symptoms) were statistically significant in accounting for 40% of the variance in sleep disturbance. Conclusion. When low income Latinas of Mexican descent report sleep problems, clinicians should probe for environmental sleep factors associated with low income, such as noise, overcrowding and exposure to trauma and violence, and refer the woman to psychotherapy and counselling rather than merely prescribing a sleep medication.
Study Objectives: To translate, back-translate and cross-language validate (English/Spanish) the Sleep Heart Health Study Sleep Habits Questionnaire for use with Spanish-speakers in clinical and research settings. Methods: Following rigorous translation and back-translation, this cross-sectional cross-language validation study recruited bilingual participants from academic, clinic, and community-based settings (N = 50; 52% women; mean age 38.8 ± 12 years; 90% of Mexican heritage). Participants completed Eng-lish and Spanish versions of the Sleep Habits Questionnaire, the Epworth Sleepiness Scale, and the Acculturation Rating Scale for Mexican Americans II one week apart in randomized order. Psychometric properties were assessed, including internal consistency, convergent validity, scale equivalence, language version intercorrelations, and exploratory factor analysis using PASW (Version18) software. Grade level readability of the sleep measure was evaluated. Results: All sleep categories (duration, snoring, apnea, insomnia symptoms, other sleep symptoms, sleep disruptors, restless legs syndrome) showed Cronbach α, Spearman-Brown coeffi cients and intercorrelations ≥ 0.700, suggesting robust internal consistency, correlation, and agreement between language versions. The Epworth correlated signifi cant-ly with snoring, apnea, sleep symptoms, restless legs, and sleep disruptors) on both versions, supporting convergent validity. Items loaded on 4 factors accounted for 68% and 67% of the variance on the English and Spanish versions, respectively. Conclusions: The Spanish-language Sleep Habits Questionnaire demonstrates conceptual and content equivalency. It has appropriate measurement properties and should be useful for assessing sleep health in community-based clinics and intervention studies among Spanish-speaking Mexican Americans. Both language versions showed readability at the fi fth grade level. Further testing is needed with larger samples. keywords: Spanish translation/validation, sleep health disparities , psychometrics, Hispanic Mexican Americans, sleep habits and culture care Citation: Baldwin CM; Choi M; McClain DB; Celaya A; Quan SF. Spanish translation and cross-language validation of a Sleep Habits Questionnaire for use in clinical and research settings. J Clin Sleep Med 2012;8(2):137-146.
OBJECTIVES: To determine how poor sleep affects the health of older ethnic minorities. DESIGN: Cross-sectional study involving a populationbased survey. SETTING: Hispanic Established Population for the Epidemiologic Study of the Elderly (H-EPESE) survey conducted in the southwestern United States. PARTICIPANTS: Two thousand two hundred fifty-six Mexican-American men and women aged 65 and older. MEASUREMENTS: The association between self-reported sleep problems and mortality over a 15-year period in a population based sample of older Mexican Americans was examined. Using five waves of data (1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008) from the H-EPESE, Cox proportional hazard models stratified according to sex were used to model the risk of death as a function of chronic sleep problems. RESULTS: Having any sleeping problems during the last month was associated with greater risk of mortality (hazard ratio = 1.14, 95% confidence interval = 1.00-1.29) in unadjusted models, although the association was attenuated after accounting for covariates. CONCLUSIONS: Similar factors explained the association between sleep and mortality in men and women: health behaviors, depressive symptoms, and health conditions. These factors are related to stress, and both may lead to poor sleep quality. Research is needed to better understand the factors moderating the relationship between sleep, mortality, and sex.