4.6 Article

Associations between everyday discrimination and sleep quality and duration among African-Americans over time in the Jackson Heart Study

Journal

SLEEP
Volume 44, Issue 12, Pages -

Publisher

OXFORD UNIV PRESS INC
DOI: 10.1093/sleep/zsab162

Keywords

discrimination; sleep duration; sleep quality; longitudinal; Jackson Heart Study

Funding

  1. National Heart, Lung, and Blood Institute (NHLBI) [K01HL138211, T32HL007901-18, 3R01HL110068-03S1, R35 HL 135818]
  2. Harvard Catalyst | The Harvard Clinical and Translational Science Center (National Center for Research Resources)
  3. National Center for Advancing Translational Sciences, National Institutes of Health Award [UL1 TR001102]
  4. Harvard University and its affiliated academic healthcare centers
  5. Harvard University [HHSN268201800013I]
  6. Tougaloo College [HHSN268201800014I]
  7. Mississippi State Department of Health [HHSN268201800015I]
  8. University of Mississippi Medical Center [HHSN268201800010I, HHSN268201800011I, HHSN268201800012I]
  9. National Institute on Minority Health and Health Disparities (NIMHD)
  10. Intramural Program at the National Institutes of Health (NIH), National Institute of Environmental Health Sciences (NIEHS) [Z1AES103325-01]

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This study investigated the longitudinal associations between everyday discrimination and sleep quality and duration among African-Americans. Results showed that increasing discrimination was associated with a greater decrease in sleep quality, while there was no association between change in discrimination and change in sleep duration.Participants who experienced higher discrimination reported shorter sleep duration, independent of stress. Further research is needed to identify interventions to reduce the burden of discrimination on sleep quality.
Study Objectives African-Americans have a high burden of poor sleep, yet, psychosocial determinants (e.g. discrimination) are understudied. We investigated longitudinal associations between everyday discrimination and sleep quality and duration among African-Americans (N = 3404) in the Jackson Heart Study. Methods At Exam 1 (2000-2004) and Exam 3 (2008-2013), participants completed the Everyday Discrimination Scale, rated their sleep quality (1 = poor to 5 = excellent), and self-reported hours of sleep. A subset of participants (N = 762) underwent 7-day actigraphy to objectively measure sleep duration and sleep quality (Sleep Exam 2012-2016). Changes in discrimination were defined as low stable (reference), increasing, decreasing, and high stable. Within-person changes in sleep from Exam 1 to Exam 3 were regressed on change in discrimination from Exam 1 to Exam 3 while adjusting for age, sex, education, income, employment, physical activity, smoking, body mass index, social support, and stress. Results At Exam 1, the mean age was 54.1 (12.0) years; 64% were female, mean sleep quality was 3.0 (1.1) and 54% were short sleepers. The distribution of the discrimination change trajectories were 54.1% low stable, 13.5% increasing, 14.6% decreasing, and 17.7% were high stable. Participants who were in the increasing (vs. low stable) discrimination group had greater decrease in sleep quality. There was no association between change in discrimination and change in sleep duration. Among Sleep Exam participants, higher discrimination was cross-sectionally associated with shorter self-reported sleep duration, independent of stress. Conclusion Discrimination is a unique stressor for African-Americans; thus, future research should identify interventions to reduce the burden of discrimination on sleep quality.

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