Who gets the best sleep? Ethnic and socioeconomic factors related to sleep complaints

Abstract

Objectives: Lower socioeconomic status is associated with short or long sleep duration and sleep disturbance (e.g., sleep apnea), which are all related to increased mortality risk. General sleep complaints, however, which may better approximate symptoms as they are experienced, have not been examined in a large population sample.

Methods: Sample consisted of n=159,856 participants from the Behavioral Risk Factor Surveillance System, representing 36 states/regions across the US. Sleep complaints were measured with a telephone survey item that assessed "trouble falling asleep," "staying asleep" or "sleeping too much." Data analysis utilized hierarchical logistic regression and Rao-Schott chi(2).

Results: Asian respondents reported the least complaints, and Hispanic/Latino and Black/African-American individuals reported fewer complaints than Whites. Lower income and educational attainment was associated with more sleep complaints. Employment was associated with less sleep complaints and unemployment with more. Married individuals reported the least sleep complaints. Significant interactions with race/ethnicity indicate that the relationship between sleep complaints and marital status, income and employment differs among groups for men, and the relationship with education differs among groups for women.

Conclusions: Rates of sleep complaints in African-American, Hispanic/Latino and Asian/Other groups were similar to Whites. Lower socioeconomic status was associated with higher rates of sleep complaint.

Figure 1

Odds Ratios (ORs) of SC for Men and Women, Across Race/Ethnicity (Reference Group = White). Among women, Asian/Other respondents reported the least SC, followed by Black/African-American and Latina respondents. These groups significantly differed from White women. Multiracial women reported significantly more SC than White women. For men, While trends for less SC compared to White men were seen in all groups, only Asian/Other men differed significantly.

Figure 2

Odds Ratios (ORs) of SC for Men and Women, Across Education Level (Reference Group = College Graduate). For both men and women, all groups reported more SC than college graduates.

Figure 3

Odds Ratios (ORs) of SC for Men and Women, Across Marital Status (Reference Group = Married). Except for widowed respondents, all groups reported significantly more SC than married respondents. The highest rates were for those never married or part of an unmarried couple.

Figure 4

Odds Ratios (ORs) of SC for Men and Women, Across Employment Status (Reference Group = Employed).For both men and women, unemployment was associated with increased SC. Employment conveyed slight benefit over self-employment and retirement in men, but not women. Rates of SC in homemakers were similar to self-employment for women, but unemployment for men.

Figure 5

Odds Ratios (ORs) of SC for Men and Women, Across Income (Reference Group = >$75,000). Decreasing income was associates with increased rates of SC in men and women. However, there were no significant differences among men earning $25,000 or more.