Goldstein Samuel J, Gaston Symielle A, McGrath John A, Jackson Chandra L
The University of North Carolina at Chapel Hill, Department of Environmental Sciences and Engineering, Chapel Hill, NC, USA.
Department of Health and Human Services, Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA.
Nat Sci Sleep. 2020 Dec 2;12:1091-1104. doi: 10.2147/NSS.S268087. eCollection 2020.
Prior studies investigating the relationship between sleep and serious psychological distress (SPD) have lacked racial/ethnic diversity and generalizability. We investigated associations between sleep and SPD among a large, nationally representative, and racially/ethnically diverse sample of US adults.
We pooled cross-sectional data from the 2004 to 2017 National Health Interview Survey. Participants self-reported sleep duration and sleep disturbances (eg, trouble falling and staying asleep). SPD was defined as a Kessler Psychological Distress Scale (K6) score ≥13. Adjusting for sociodemographic, health behavior, and clinical characteristics, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) of SPD for each sleep characteristic, overall and by race/ethnicity.
Among 316,840 participants, the mean age ± standard error was 46.9 ± 0.1 years, 52% were women, 75% were non-Hispanic (NH)-White, 16% NH-Black, and 9% Hispanic/Latinx. The prevalence of SPD was 3.4% for NH-Whites, 4.1% for NH-Blacks, and 4.5% for Hispanics/Latinxs. Participants with <7 hours versus 7-9 hours of sleep duration were more likely to have SPD, and the magnitude of the association was strongest among NH-Black participants (PR=3.50 [95% CI: 2.97-4.13], PR =2.95 [2.42-3.61], and PR=2.66 [2.44-2.89]). Positive associations between sleep disturbances and SPD were generally stronger among NH-Black and Hispanic/Latinx compared to NH-White adults.
Poor sleep health was positively associated with SPD, and the magnitude of the association was generally stronger among racial/ethnic minorities. Future investigations should prospectively focus on the determinants and health consequences of SPD attributable to objectively measured sleep across racial/ethnic groups.
先前关于睡眠与严重心理困扰（SPD）之间关系的研究缺乏种族/民族多样性和普遍性。我们在一个具有全国代表性、种族/民族多样化的美国成年人样本中，调查了睡眠与SPD之间的关联。
我们汇总了2004年至2017年国家健康访谈调查的横断面数据。参与者自行报告睡眠时间和睡眠障碍（如入睡困难和睡眠维持困难）。SPD被定义为凯斯勒心理困扰量表（K6）得分≥13。在调整了社会人口统计学、健康行为和临床特征后，我们使用稳健方差的泊松回归来估计每种睡眠特征下SPD的患病率比（PRs）和95%置信区间（CIs），总体以及按种族/民族划分。
在316,840名参与者中，平均年龄±标准误为46.9±0.1岁，52%为女性，75%为非西班牙裔（NH）白人，16%为NH黑人，9%为西班牙裔/拉丁裔。NH白人的SPD患病率为3.4%，NH黑人为4.1%，西班牙裔/拉丁裔为4.5%。睡眠时间<7小时的参与者比睡眠时间为7 - 9小时的参与者更有可能患有SPD，这种关联的强度在NH黑人参与者中最强（PR = 3.50 [95% CI：2.97 - 4.13]，PR = 2.95 [2.42 - 3.61]，PR = 2.66 [2.44 - 2.89]）。与NH白人成年人相比，睡眠障碍与SPD之间的正相关在NH黑人和西班牙裔/拉丁裔中通常更强。
睡眠健康不佳与SPD呈正相关，且这种关联的强度在种族/民族少数群体中通常更强。未来的研究应前瞻性地关注不同种族/民族群体中，由客观测量的睡眠所导致的SPD的决定因素和健康后果。
