University of Maryland School of Public Health, Department of Epidemiology and Biostatistics, College Park, MD 20742.
University of Maryland, College Park, School of Public Policy, College Park, MD 20742.
Sleep. 2021 Oct 11;44(10). doi: 10.1093/sleep/zsab109.
To examine the association between discrimination and sleep duration and difficulty among Asians and Pacific Islanders (APIs) in the United States, and to test nativity and ethnic identity (EI) as effect modifiers.
This cross-sectional study of 1,765 adults from the National Epidemiology Study of Alcohol and Related Conditions III, assessed discrimination using the Experiences of Discrimination scale. Discrimimation was classified as low, moderate, and high. Regression models were used to examine self-reported sleep duration and difficulty.
In bivariate analyses, individuals with high discrimination had the shortest sleep and reported sleep difficulty most often. Using linear models adjusted for sociodemographic and health characteristics, moderate and high discrimination were associated with 9 min (standard error [SE]: 4.8, p < .10) and 14.4 min (SE: 6.0, p < .05) less sleep, respectively, relative to low discrimination. Individuals with moderate and high discrimination had higher prevalence of sleep difficulty compared to those with low discrimination (prevalence ratio [PR]: 1.51, 95% confidence interval [CI]: 1.14-1.99 and PR: 1.73, 95% CI: 1.33-2.24, respectively). Interaction effect was observed in sleep difficulty by nativity and EI, but not duration. The association between discrimination and sleep difficulty was stronger among U.S.-born relative to foreign-born participants. Among participants with low EI, moderate and high discrimination were associated with sleep difficulty, whereas among those with high EI, only high discrimination displayed this association.
Discrimination is associated with sleep duration and difficulty, and varies by nativity and EI. Research is needed to improve sleep among APIs that experience discrimination.
在美国的亚洲及太平洋岛民（APIs）中，研究歧视与睡眠时长和睡眠困难之间的关系，并检验出生地和民族认同（EI）的调节作用。
这是一项横断面研究，共纳入了来自国家酒精流行病学研究 III 期的 1765 名成年人，使用歧视经历量表评估歧视。歧视被分为低、中、高三个等级。回归模型用于检查自我报告的睡眠时长和困难。
在双变量分析中，高歧视个体的睡眠最短，且报告睡眠困难的频率最高。使用线性模型调整了社会人口学和健康特征后，中度和高度歧视与低歧视相比，分别与睡眠时长减少 9 分钟（标准误 [SE]：4.8，p<.10）和 14.4 分钟（SE：6.0，p<.05）相关。与低歧视相比，中度和高度歧视的个体睡眠困难的患病率更高（患病比 [PR]：1.51，95%置信区间 [CI]：1.14-1.99 和 PR：1.73，95% CI：1.33-2.24）。在睡眠困难方面观察到了出生地和 EI 的交互效应，但在睡眠时长方面没有观察到交互效应。与外国出生的参与者相比，美国出生的参与者中，歧视与睡眠困难之间的关联更强。在 EI 较低的参与者中，中度和高度歧视与睡眠困难相关，而在 EI 较高的参与者中，只有高度歧视与睡眠困难相关。
歧视与睡眠时长和困难有关，且因出生地和 EI 而异。需要开展研究以改善经历歧视的亚太裔的睡眠。
