Johnson Dayna A, Lisabeth Lynda, Lewis Tené T, Sims Mario, Hickson DeMarc A, Samdarshi Tandaw, Taylor Herman, Diez Roux Ana V
Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI.
Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.
Sleep. 2016 Jul 1;39(7):1411-9. doi: 10.5665/sleep.5974.
Studies have shown that psychosocial stressors are related to poor sleep. However, studies of African Americans, who may be more vulnerable to the impact of psychosocial stressors, are lacking. Using the Jackson Heart Study (JHS) baseline data, we examined associations of psychosocial stressors with sleep in 4,863 African Americans.
We examined cross-sectional associations between psychosocial stressors and sleep duration and quality in a large population sample of African Americans. Three measures of psychosocial stress were investigated: the Global Perceived Stress Scale (GPSS); Major Life Events (MLE); and the Weekly Stress Inventory (WSI). Sleep was assessed using self-reported hours of sleep and sleep quality rating (1 = poor; 5 = excellent). Multinomial logistic and linear regression models were used to examine the association of each stress measure (in quartiles) with continuous and categorical sleep duration (< 5 ("very short"), 5-6 h ("short") and > 9 h ("long") versus 7 or 8 h ("normal"); and with sleep quality after adjustment for demographics and risk factors (body mass index, hypertension, diabetes, physical activity).
Mean age of the sample was 54.6 years and 64% were female. Mean sleep duration was 6.4 + 1.5 hours, 54% had a short sleep duration, 5% had a long sleep duration, and 34% reported a "poor" or "fair" sleep quality. Persons in the highest GPSS quartile had higher odds of very short sleep (odds ratio: 2.87, 95% confidence interval [CI]: 2.02, 4.08), higher odds of short sleep (1.72, 95% CI: 1.40, 2.12), shorter average sleep duration (Δ = -33.6 min (95% CI: -41.8, -25.4), and reported poorer sleep quality (Δ = -0.73 (95% CI: -0.83, -0.63) compared to those in the lowest quartile of GPSS after adjustment for covariates. Similar patterns were observed for WSI and MLE. Psychosocial stressors were not associated with long sleep. For WSI, effects of stress on sleep duration were stronger for younger (< 60 y) and college-educated African-Americans.
Psychosocial stressors are associated with higher odds of short sleep, lower average sleep duration, and lower sleep quality in African Americans. Psychosocial stressors may be a point of intervention among African Americans for the improvement of sleep and downstream health outcomes.
研究表明，心理社会压力源与睡眠质量差有关。然而，针对可能更容易受到心理社会压力源影响的非裔美国人的研究却很缺乏。我们利用杰克逊心脏研究（JHS）的基线数据，调查了4863名非裔美国人心理社会压力源与睡眠之间的关联。
我们在一个非裔美国人大规模人群样本中，研究了心理社会压力源与睡眠时间和质量之间的横断面关联。我们调查了三种心理社会压力测量指标：总体感知压力量表（GPSS）；重大生活事件（MLE）；以及每周压力量表（WSI）。睡眠通过自我报告的睡眠时间和睡眠质量评分进行评估（1 = 差；5 = 优）。采用多项逻辑回归和线性回归模型，在调整人口统计学和风险因素（体重指数、高血压、糖尿病、身体活动）后，研究每种压力测量指标（四分位数）与连续和分类睡眠时间（<5小时（“非常短”）、5 - 6小时（“短”）和>9小时（“长”）与7或8小时（“正常”））以及睡眠质量之间的关联。
样本的平均年龄为54.6岁，64%为女性。平均睡眠时间为6.4±1.5小时，54%的人睡眠时间短，5%的人睡眠时间长，34%的人报告睡眠质量“差”或“一般”。在调整协变量后，GPSS四分位数最高的人群睡眠非常短的几率更高（优势比：2.87，95%置信区间[CI]：2.02，4.08），睡眠时间短的几率更高（1.72，95%CI：1.40，2.12），平均睡眠时间更短（Δ = -33.6分钟（95%CI：-41.8，-25.4）），且报告的睡眠质量更差（Δ = -0.73（95%CI：-0.83，-0.63）），与GPSS四分位数最低的人群相比。WSI和MLE也观察到类似模式。心理社会压力源与长睡眠无关。对于WSI，压力对睡眠时间的影响在年龄较小（<60岁）和受过大学教育的非裔美国人中更强。
心理社会压力源与非裔美国人睡眠时间短的几率更高、平均睡眠时间更低以及睡眠质量更低有关。心理社会压力源可能是非裔美国人改善睡眠和下游健康结果的一个干预点。
