title: Racial/Ethnic Differences in Sleep Disturbances: The Multi-Ethnic Study of Atherosclerosis (MESA).
abstract: OBJECTIVE
  There is limited research on racial/ethnic variation in sleep disturbances. This study aimed to quantify the distributions of objectively measured sleep disordered breathing (SDB), short sleep duration, poor sleep quality, and self-reported sleep disturbances (e.g., insomnia) across racial/ethnic groups.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Six US communities.
  
  
  METHODS
  Racially/ethnically diverse men and women aged 54-93 y in the Multi-Ethnic Study of Atherosclerosis Sleep Cohort (n = 2,230).
  
  
  METHODS
  N/A.
  
  
  RESULTS
  Information from polysomnography-measured SDB, actigraphy-measured sleep duration and quality, and self-reported daytime sleepiness were obtained between 2010 and 2013. Overall, 15.0% of individuals had severe SDB (apnea-hypopnea index [AHI] ≥ 30); 30.9% short sleep duration (< 6 h); 6.5% poor sleep quality (sleep efficiency < 85%); and 13.9% had daytime sleepiness. Compared with Whites, Blacks had higher odds of sleep apnea syndrome (AHI ≥ 5 plus sleepiness) (sex-, age-, and study site-adjusted odds ratio [OR] = 1.78, 95% confidence interval [CI]: 1.20, 2.63), short sleep (OR = 4.95, 95% CI: 3.56, 6.90), poor sleep quality (OR = 1.57, 95% CI: 1.00, 2.48), and daytime sleepiness (OR = 1.89, 95% CI: 1.38, 2.60). Hispanics and Chinese had higher odds of SDB and short sleep than Whites. Among non-obese individuals, Chinese had the highest odds of SDB compared to Whites. Only 7.4% to 16.2% of individuals with an AHI ≥ 15 reported a prior diagnosis of sleep apnea.
  
  
  CONCLUSIONS
  Sleep disturbances are prevalent among middle-aged and older adults, and vary by race/ethnicity, sex, and obesity status. The high prevalence of sleep disturbances and undiagnosed sleep apnea among racial/ethnic minorities may contribute to health disparities.
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, MA.
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Medicine, Harvard Medical School; Brigham and Women's Hospital and Beth Israel Deaconess Medical School, Boston, MA.
authors.forename: Rui
authors.initials: R
authors.lastname: Wang
authors.affiliation: Department of Neurobiology, Northwestern University School of Medicine, Chicago, IL.
authors.forename: Phyllis
authors.initials: P
authors.lastname: Zee
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, Minnesota, Minneapolis, MN.
authors.forename: Pamela L
authors.initials: PL
authors.lastname: Lutsey
authors.affiliation: Department of Medicine, Harvard Medical School; Brigham and Women's Hospital and Beth Israel Deaconess Medical School, Boston, MA.
authors.forename: Sogol
authors.initials: S
authors.lastname: Javaheri
authors.affiliation: Center for Behavioral Cardiovascular Health, Department of Medicine, Columbia University Medical Center, New York, NY.
authors.forename: Carmela
authors.initials: C
authors.lastname: Alcántara
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston, MA.
authors.forename: Chandra L
authors.initials: CL
authors.lastname: Jackson
authors.affiliation: Department of Epidemiology, Harvard School of Public Health, Boston, MA.
authors.forename: Michelle A
authors.initials: MA
authors.lastname: Williams
authors.affiliation: Department of Medicine, Harvard Medical School; Brigham and Women's Hospital and Beth Israel Deaconess Medical School, Boston, MA.
authors.forename: Susan
authors.initials: S
authors.lastname: Redline
mesh_terms: D056044:Actigraphy; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data; D050197:Atherosclerosis / Q000453:epidemiology; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D016017:Odds Ratio; D017286:Polysomnography; D015995:Prevalence; D044469:Racial Groups / Q000706:statistics & numerical data*; D057566:Self Report; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000453:epidemiology; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000453:epidemiology; D012894:Sleep Stages / Q000502:physiology; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
keywords: apnea-hypopnea index; body mass index; daytime sleepiness; obesity; polysomnography; race/ethnicity; sleep disordered breathing; sleep disturbance; sleep duration; sleep quality