title: Differences in short and long sleep durations between blacks and whites attributed to emotional distress: analysis of the National Health Interview Survey in the United States.
abstract: The current study examined the role of emotional distress in explaining racial/ethnic differences in unhealthy sleep duration.
  
  
  
  Data from the 2004-2013 National Health Interview Survey were analyzed using SPSS 20.
  
  
  
  Data were collected through personal household interviews in the United States.
  
  
  
  Of the total 261,686 participants (age≥18 years), 17.0% were black, 83.0% were white, and the mean age was 48 years (SE=0.04).
  
  
  
  To ascertain total sleep duration, participants were asked, "How many hours of sleep do you get on average in a 24-hour period?" Sleep duration was coded as short sleep (<7hours), average sleep (7-8hours), or long sleep (>8hours). Emotional distress-feeling sad, nervous, restless, hopeless, worthless, and burdened over a 30-day period-was measured using Kessler-6, a 6-item screening scale.
  
  
  
  Of the participants reporting significant emotional distress (4.0% black, 3.5% white), χ2analyses revealed that a higher percentage of blacks, compared with whites, reported unhealthy sleep durations. Relative to Whites, Blacks had increased prevalence of short sleep (prevalence ratio=1.32, P<.001) or long sleep (odds ratio =1.189, P<.001). The interaction between race/ethnicity and emotional distress was significantly associated with short (prevalence ratio=0.99, P<.001) and long sleep (odds ratio=0.98, P<.001) durations.
  
  
  
  Individuals of the black race/ethnicity or those reporting greater levels of emotional distress are more likely to report short or long sleep duration. Emotional distress might partially explain racial/ethnic differences in unhealthy sleep duration between blacks and whites.
authors.affiliation: NYU School of Medicine, Department of Population Health, Center for Healthful Behavior Change. Electronic address: Azizi.Seixas@nyumc.org.
authors.forename: Azizi A
authors.initials: AA
authors.lastname: Seixas
authors.affiliation: NYU School of Medicine, Department of Population Health, Center for Healthful Behavior Change.
authors.forename: Emmanuella
authors.initials: E
authors.lastname: Auguste
authors.affiliation: NYU School of Medicine, Department of Population Health, Center for Healthful Behavior Change.
authors.forename: Mark
authors.initials: M
authors.lastname: Butler
authors.affiliation: The University of the West Indies, Mona, Jamaica.
authors.forename: Caryl
authors.initials: C
authors.lastname: James
authors.affiliation: NYU School of Medicine, Department of Population Health, Center for Healthful Behavior Change.
authors.forename: Valerie
authors.initials: V
authors.lastname: Newsome
authors.affiliation: NYU School of Medicine, Department of Population Health, Center for Healthful Behavior Change.
authors.forename: Evan
authors.initials: E
authors.lastname: Auguste
authors.affiliation: Universidade Federal Fluminense, Niteroi, Rio de Janeiro, Brazil.
authors.forename: Vilma Aparecida
authors.initials: VA
authors.lastname: da Silva Fonseca
authors.affiliation: Universidade Federal Fluminense, Niteroi, Rio de Janeiro, Brazil; Psychiatrische Dienste Graubuenden (PDGR), Plazza Paracelsus 2, 7500 St Moritz, Switzerland; Universitaere Psychiatrische Kliniken Basel, Switzerland (UPK), Wilhelm Klein-Strasse 27, 4012 Basel, Switzerland; Albert Einstein College of Medicine (AECOM), Department of Psychiatry and Behavioral Sciences, 3331 Bainbridge Ave, Bronx, NY 10467, USA.
authors.forename: Andres
authors.initials: A
authors.lastname: Schneeberger
authors.affiliation: NYU School of Medicine, Department of Population Health, Center for Healthful Behavior Change.
authors.forename: Ferdinand
authors.initials: F
authors.lastname: Zizi
authors.affiliation: NYU School of Medicine, Department of Population Health, Center for Healthful Behavior Change.
authors.forename: Girardin
authors.initials: G
authors.lastname: Jean-Louis
mesh_terms: D000328:Adult; D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D005260:Female; D054624:Health Status Disparities; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012890:Sleep; D013315:Stress, Psychological / Q000208:ethnology*; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D044465:White People / Q000523:psychology* / Q000706:statistics & numerical data
keywords: Emotional distress; Race; Sleep duration