title: Racial/Ethnic Differences in Insomnia Trajectories Among U.S. Older Adults.
abstract: Insomnia is reported to be more prevalent in minority racial/ethnic groups. Little is known, however, about racial/ethnic differences in changes in insomnia severity over time, particularly among older adults. We examined racial/ethnic differences in trajectories of insomnia severity among middle-aged and older adults.
  
  
  
  Data were drawn from five waves of the Health and Retirement Study (2002-2010), a nationally representative longitudinal biennial survey of adults aged > 50 years.
  
  
  
  Population-based.
  
  
  
  22,252 participants from non-Hispanic white, non-Hispanic black, Hispanic, and other racial/ethnic groups.
  
  
  
  Participants reported the severity of four insomnia symptoms; summed scores ranged from 4 (no insomnia) to 12 (severe insomnia). We assessed change in insomnia across the five waves as a function of race/ethnicity.
  
  
  
  Across all participants, insomnia severity scores increased 0.19 points (95% CI: 0.14-0.24; t = 7.52; design df = 56; p < 0.001) over time after adjustment for sex, race/ethnicity, education, and baseline age. After adjusting for the number of accumulated health conditions and body mass index, this trend decreased substantially and even changed direction (B = -0.24; 95% CI: -0.29 to -0.19; t = -9.22; design df = 56; p < 0.001). The increasing trajectory was significantly more pronounced in Hispanics compared with non-Hispanic whites, even after adjustment for number of accumulated health conditions, body mass index, and number of depressive symptoms.
  
  
  
  Although insomnia severity increases with age-largely due to the accumulation of health conditions-this trend appears more pronounced among Hispanic older adults than in non-Hispanic whites. Further research is needed to determine the reasons for a different insomnia trajectory among Hispanics.
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA. Electronic address: cnkaufmann@ucsd.edu.
authors.forename: Christopher N
authors.initials: CN
authors.lastname: Kaufmann
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Ramin
authors.initials: R
authors.lastname: Mojtabai
authors.affiliation: Chester M. Pierce, MD, Division of Global Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Hock
authors.affiliation: Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Roland J
authors.initials: RJ
authors.lastname: Thorpe
authors.affiliation: Gerontology Research Centre, Simon Fraser University, Vancouver, BC, Canada.
authors.forename: Sarah L
authors.initials: SL
authors.lastname: Canham
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Lian-Yu
authors.initials: LY
authors.lastname: Chen
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
authors.forename: Alexandra M V
authors.initials: AM
authors.lastname: Wennberg
authors.affiliation: School of Health and Applied Human Sciences, University of North Carolina Wilmington, Wilmington, NC, USA.
authors.forename: Lenis P
authors.initials: LP
authors.lastname: Chen-Edinboro
authors.affiliation: Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Adam P
authors.initials: AP
authors.lastname: Spira
mesh_terms: D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000375:Aging / Q000523:psychology*; D015992:Body Mass Index; D005260:Female; D005431:Florida / Q000453:epidemiology; D006297:Health Services Accessibility; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D007319:Sleep Initiation and Maintenance Disorders / Q000208:ethnology*; D012959:Socioeconomic Factors; D044465:White People / Q000706:statistics & numerical data*
keywords: Aging; Chronic health conditions; Disparities; Insomnia