Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
University of Pennsylvania, Philadelphia, Pennsylvania.
J Clin Sleep Med. 2017 Nov 15;13(11):1281-1288. doi: 10.5664/jcsm.6798.
Community-based research indicates that Black preschoolers tend to have more bedtime difficulties and are at higher risk for obstructive sleep apnea (OSA) compared to White preschoolers. This study examined differences in sleep patterns and problems by race among a clinical sample of Black and White preschoolers at an outpatient sleep clinic.
Data were collected from electronic medical records for 125 children ages 2-5 years (mean = 3.37 years, 64.0% White, 36.0% Black; 59.2% male) presenting at a pediatric sleep clinic in an academic medical center. Neighborhood income data were based on ZIP codes entered into the United States Census Bureau's American Fact Finder.
Black patients (51.1%) were significantly more likely than White patients (20.0%) to bed-share with a caregiver (χ = 12.99, ≤ .001). There were no other significant differences in presenting sleep patterns (bed/wake times, sleep onset latency, naps, night awakenings, or sleep opportunity). Logistic regressions showed that White patients were more likely to present with difficulty falling/staying asleep and receive an insomnia diagnosis, and Black patients were more likely to present with OSA-related concerns and receive a diagnosis of suspected OSA, even when controlling for relevant sociodemographic covariates.
In contrast to community-based research, Black and White children showed similar sleep patterns. However, there were differences by race in referral questions and diagnoses. Findings suggest the need to consider caregiver perceptions and other sociocultural factors that may contribute to differential rates of presentation for sleep services, as well as potential health disparities in this regard.
基于社区的研究表明，与白人学龄前儿童相比，黑人学龄前儿童往往更难按时入睡，并且患阻塞性睡眠呼吸暂停（OSA）的风险更高。本研究通过对一个儿科睡眠诊所的黑人及白人学龄前儿童的临床样本，调查了不同种族间睡眠模式和睡眠问题的差异。
从电子病历中收集了 125 名 2-5 岁（平均年龄 3.37 岁，64.0%为白人，36.0%为黑人；59.2%为男性）在学术医疗中心的儿科睡眠诊所就诊的儿童的数据。社区收入数据基于输入到美国人口普查局的美国事实查找器的邮政编码。
与白人患者（20.0%）相比，黑人患者（51.1%）与护理人员同床的可能性显著更高（χ = 12.99， ≤.001）。在就诊时的睡眠模式（起床时间、入睡潜伏期、小睡、夜间觉醒次数或睡眠机会）方面没有其他显著差异。逻辑回归显示，白人患者更有可能出现入睡困难/难以入睡和失眠诊断，而黑人患者更有可能出现与 OSA 相关的问题并被诊断为疑似 OSA，即使在控制了相关社会人口学协变量的情况下也是如此。
与社区研究相反，黑人和白人儿童的睡眠模式相似。然而，在转诊问题和诊断方面存在种族差异。研究结果表明，需要考虑护理人员的看法和其他社会文化因素，这些因素可能会导致对睡眠服务的不同就诊率，以及在这方面存在潜在的健康差异。
