title: Sleep symptoms, race/ethnicity, and socioeconomic position.
abstract: OBJECTIVE
  Growing evidence indicates sleep is a major public health issue. Race/ethnicity and socioeconomics may contribute to sleep problems. This study assessed whether sleep symptoms were more prevalent among minorities and/or the socioeconomically disadvantaged.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Epidemiologic survey.
  
  
  METHODS
  2007-2008 National Health and Nutrition Examination Survey (N = 4,081).
  
  
  METHODS
  None.
  
  
  RESULTS
  Sociodemographics included age, sex, race/ethnicity, marital status, and immigration. Socioeconomics included poverty, education, private insurance, and food insecurity. Sleep symptoms assessed were sleep latency > 30 min, difficulty falling asleep, sleep maintenance difficulties, early morning awakenings, non-restorative sleep, daytime sleepiness, snorting/gasping, and snoring. Decreased reported problems for most symptoms were found among minorities, immigrants, and lower education levels. In general, in fully adjusted models, long sleep latency was associated with female gender, being black/African American, lower education attainment, no private insurance, and food insecurity. Difficulty falling asleep, sleep maintenance difficulties, early morning awakenings, and non-restorative sleep were also associated with female gender and food insecurity. Daytime sleepiness was seen in female and divorced respondents. Snorting/gasping was more prevalent among male, other-Hispanic/Latino, and 9(th)- to 11(th)-grade-level respondents. Snoring was prevalent among male, other-Hispanic/Latino, less-educated, and food-insecure respondents.
  
  
  CONCLUSIONS
  Sleep symptoms were associated with multiple sociodemographic and economic factors, though these relationships differed by predictor and sleep outcome. Also, reports depended on question wording.
authors.affiliation: Center for Sleep and Circadian Neurobiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA. Grandner@gmail.com
authors.forename: Michael A
authors.initials: MA
authors.lastname: Grandner
authors.forename: Megan E Ruiter
authors.initials: ME
authors.lastname: Petrov
authors.forename: Pinyo
authors.initials: P
authors.lastname: Rattanaumpawan
authors.forename: Nicholas
authors.initials: N
authors.lastname: Jackson
authors.forename: Alec
authors.initials: A
authors.lastname: Platt
authors.forename: Nirav P
authors.initials: NP
authors.lastname: Patel
mesh_terms: D000367:Age Factors; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007182:Income / Q000706:statistics & numerical data; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009749:Nutrition Surveys / Q000706:statistics & numerical data; D044469:Racial Groups / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012737:Sex Factors; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
keywords: Insomnia; health disparities; race/ethnicity; sleep disorders; socioeconomic status