Unfair treatment is associated with poor sleep in African American and Caucasian adults: Pittsburgh SleepSCORE project

Abstract

Objective: To test the association between self-reported unfair treatment and objective and self-reported sleep characteristics in African American and Caucasian adults.

Design: Cross-sectional study of 97 African American and 113 Caucasian middle-aged adults.

Main outcome measures: Participants completed: (a) two-night in-home, polysomnography (PSG) sleep study, (b) sleep diaries and actigraph assessments across 9 days and nights, and (c) self-report measures of sleep quality in the past month, and daytime sleepiness in the past 2 weeks.

Results: Greater unfair treatment was associated with reports of poorer self-reported sleep quality and greater daytime sleepiness, shorter sleep duration, and lower sleep efficiency as measured by actigraphy and PSG, and a smaller proportion of rapid eye movement (REM) sleep. Racial/ethnic differences were few. Exploratory analyses showed that nightly worry partially mediated the associations of unfair treatment with sleep quality, daytime sleepiness, sleep efficiency (actigraphy), and proportion of REM sleep.

Conclusion: Perceptions of unfair treatment are associated with sleep disturbances in both African American and Caucasian adults. Future studies are needed to identify the pathways that account for the association between unfair treatment and sleep.

Figure 1

Figures 1a–d. Mediational models testing the association between unfair treatment and sleep quality as measured by the PSQI, daytime sleepiness as measured by the Epworth, sleep efficiency as measured by actigraphy, and rapid eye movement as partially accounted for by nightly worry reported using the diary in the full sample. In all models, age, sex, race/ethnicity, BMI, hypertensive status and/or related medication use and composite SES were covariates.

Figure 1

Figures 1a–d. Mediational models testing the association between unfair treatment and sleep quality as measured by the PSQI, daytime sleepiness as measured by the Epworth, sleep efficiency as measured by actigraphy, and rapid eye movement as partially accounted for by nightly worry reported using the diary in the full sample. In all models, age, sex, race/ethnicity, BMI, hypertensive status and/or related medication use and composite SES were covariates.