title: Sleep disturbances, quality of life, and ethnicity: the Sleep Heart Health Study.
abstract: OBJECTIVE
  To compare health-related quality of life (HR-QOL) across subgroups defined by sleep disturbances and ethnicity.
  
  
  METHODS
  Men (47%) and women (53%) Sleep Heart Health Study participants age 40 and older (N = 5237) underwent overnight polysomnography and completed self-report questionnaires on symptoms of sleep disturbances. The physical and mental composite scales (PCS and MCS) of the Medical Outcomes Study 36-item short form survey assessed HR-QOL and were compared to sleep data.
  
  
  RESULTS
  Participants self-identified as Caucasian/White (n = 4482, 86%), African American/Black (n = 490, 9%), or Hispanic/Mexican American (n = 265, 5%). The prevalence of obstructive sleep apnea (OSA) was 17%, frequent snoring was 34%, difficulty initiating or maintaining sleep (DIMS; insomnia symptoms) was 30%, and excessive daytime sleepiness (EDS) was 25%. African American participants with frequent snoring, insomnia symptoms, or EDS had significantly poorer physical health compared to Caucasians (p < 0.001). Hispanics with frequent snoring, insomnia symptoms, or EDS had significantly poorer mental health than Caucasian participants (p <0.001). Neither PCS nor MCS scores differed significantly across ethnic subgroups for participants with moderate to severe OSA (respiratory disturbance index > 15, 4% desaturation).
  
  
  CONCLUSIONS
  Across ethnic/racial subgroups, sleep disturbances are associated with worse physical and better mental HR-QOL than the U.S. norm, but this relationship may be moderated by comorbid health conditions. This study replicates and extends prior research indicating differences among minority and non-minority participants and highlights the need for future studies of sleep disturbances with larger samples of minorities that control for comorbid health conditions.
authors.affiliation: Arizona State University College of Nursing and Health Innovation, Phoenix, AZ 85004, USA. carol.baldwin@asu.edu
authors.forename: Carol M
authors.initials: CM
authors.lastname: Baldwin
authors.forename: Ann-Margret
authors.initials: AM
authors.lastname: Ervin
authors.forename: Mary Z
authors.initials: MZ
authors.lastname: Mays
authors.forename: John
authors.initials: J
authors.lastname: Robbins
authors.forename: Shirin
authors.initials: S
authors.lastname: Shafazand
authors.forename: Joyce
authors.initials: J
authors.lastname: Walsleben
authors.forename: Terri
authors.initials: T
authors.lastname: Weaver
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data; D015331:Cohort Studies; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006304:Health Status; D006331:Heart Diseases / Q000453:epidemiology; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008603:Mental Health / Q000706:statistics & numerical data; D008875:Middle Aged; D017286:Polysomnography / Q000379:methods; D015995:Prevalence; D011788:Quality of Life; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology; D007319:Sleep Initiation and Maintenance Disorders / Q000453:epidemiology; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D012913:Snoring / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
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