Department of Psychiatry, Columbia University Irving Medical Center, New York, NY, USA.
Division of Sleep Medicine, Department of Neurology, and Department of Obstetrics & Gynecology, University of Michigan, Ann Arbor, MI, USA.
Sleep. 2022 Sep 8;45(9). doi: 10.1093/sleep/zsac075.
In the United States, racial/ethnic minoritized groups experience worse sleep than non-Hispanic Whites (nHW), but less is known about pregnant people. This is a key consideration since poor sleep during pregnancy is common and associated with increased risk of adverse perinatal outcomes. This study reports the prevalence of subjective sleep measures in a multi-racial/ethnic pregnant population from the Environmental influences on Child Health Outcomes (ECHO) program. Participants' self-reported race and ethnicity were grouped into: nHW, non-Hispanic Black/African American (nHB/AA), Hispanic, non-Hispanic Asian (nHA). Analyses examined trimester-specific (first (T1), second (T2), third (T3)) nocturnal sleep duration, quality, and disturbances (Pittsburgh Sleep Quality Index and ECHO maternal sleep health questionnaire). Linear or multinomial regressions estimated the associations between race/ethnicity and each sleep domain by trimester, controlling for body mass index and age, with nHW as reference group. We repeated analyses within maternal education strata. nHB/AA participants reported shorter sleep duration (T2: β = -0.55 [-0.80,-0.31]; T3: β = -0.65 [-0.99,-0.31]) and more sleep disturbances (T2: β = 1.92 [1.09,2.75]; T3: β = 1.41 [0.09,2.74]). Hispanic participants reported longer sleep duration (T1: β = 0.22 [0.00004,0.44]; T2: β = 0.61 [0.47,0.76]; T3: β = 0.46 [0.22,0.70]), better sleep quality (Reference group: Very good. Fairly good T1: OR = 0.48 [0.32,0.73], T2: OR = 0.36 [0.26,0.48], T3: OR = 0.31 [0.18,0.52]. Fairly bad T1: OR = 0.27 [0.16,0.44], T2: OR = 0.46 [0.31, 0.67], T3: OR = 0.31 [0.17,0.55]), and fewer sleep disturbances (T2: β = -0.5 [-1.0,-0.12]; T3: β = -1.21 [-2.07,-0.35]). Differences persisted within the high-SES subsample. Given the stark racial/ethnic disparities in perinatal outcomes and their associations with sleep health, further research is warranted to investigate the determinants of these disparities.
在美国，与非西班牙裔白人（nHW）相比，少数族裔经历着更糟糕的睡眠，而孕妇的情况则知之甚少。这是一个关键的考虑因素，因为怀孕期间睡眠质量差很常见，而且与增加不良围产期结局的风险有关。本研究报告了环境对儿童健康结果（ECHO）计划中多种族/族裔孕妇人群的主观睡眠测量结果。参与者的自我报告种族和族裔被分为：nHW、非西班牙裔黑人和非洲裔美国人（nHB/AA）、西班牙裔、非西班牙裔亚裔（nHA）。分析检查了特定于三胞胎的（第一（T1）、第二（T2）、第三（T3））夜间睡眠持续时间、质量和干扰（匹兹堡睡眠质量指数和 ECHO 孕产妇睡眠健康问卷）。线性或多项回归估计了每个种族/族裔与每个睡眠域的关联，通过 trimester 进行控制，控制体重指数和年龄，以 nHW 为参考组。我们在产妇教育阶层内重复了分析。nHB/AA 参与者报告的睡眠时间更短（T2：β= -0.55[-0.80，-0.31]；T3：β= -0.65[-0.99，-0.31]），睡眠干扰更多（T2：β= 1.92[1.09，2.75]；T3：β= 1.41[0.09，2.74]）。西班牙裔参与者报告的睡眠时间更长（T1：β= 0.22[0.00004，0.44]；T2：β= 0.61[0.47，0.76]；T3：β= 0.46[0.22，0.70]），睡眠质量更好（参考组：非常好。相当好的 T1：OR=0.48[0.32，0.73]，T2：OR=0.36[0.26，0.48]，T3：OR=0.31[0.18，0.52]。相当差的 T1：OR=0.27[0.16，0.44]，T2：OR=0.46[0.31，0.67]，T3：OR=0.31[0.17，0.55]），睡眠干扰更少（T2：β= -0.5[-1.0，-0.12]；T3：β= -1.21[-2.07，-0.35]）。在高 SES 子样本中，差异仍然存在。鉴于围产期结局存在明显的种族/族裔差异，以及它们与睡眠健康的关联，有必要进一步研究这些差异的决定因素。
