Rubi Sofia, Monk J Kale, Shoemaker Sydney, Miller Colten, Prabhu Nivedita, Flores Lisa Y, Bernard Donte, McCrae Christina S, Borsari Brian, Miller Mary Beth
Department of Psychiatry, University of Missouri, School of Medicine, Columbia, Missouri, USA.
Department of Human Development and Family Science, University of Missouri College of Education & Human Development, Columbia, Missouri, USA.
J Sleep Res. 2024 Apr;33(2):e14063. doi: 10.1111/jsr.14063. Epub 2023 Oct 1.
Few studies have examined racial/ethnic differences in rates and correlates of insomnia among veterans. This study compared rates of insomnia and interest in sleep treatment among veterans of diverse racial/ethnic backgrounds. Consistent with the 3P model, we tested racial discrimination as a predictor of insomnia, with post-traumatic stress disorder symptoms and romantic partners as perpetuating and protective moderators of this association, respectively. A total of 325 veterans (N = 236 veterans of colour; 12% Asian, 36% Black, 14% Hispanic/Latine) completed questionnaires online from remote locations. Descriptive statistics were used to compare patterns across racial/ethnic groups. Linear regression was used to test moderators of the association between racial discrimination and insomnia severity. Overall, 68% of participants screened positive for insomnia: 90% of Asian; 79% of Hispanic/Latine; 65% of Black; and 58% of White participants. Of those, 74% reported interest in sleep treatment, and 76% of those with partners reported interest in including their partner in treatment. Racial discrimination and post-traumatic stress disorder were correlated with more severe insomnia, while romantic partners were correlated with less severe insomnia. Only post-traumatic stress disorder moderated the association between racial discrimination and insomnia severity. Rates of insomnia were highest among Asian and Hispanic/Latine participants, yet these groups were among the least likely to express interest in sleep treatment. Racial discrimination may exacerbate insomnia symptoms among veterans, but only among those who do not already have disturbed sleep in the context of post-traumatic stress disorder. Romantic partners may serve as a protective factor in insomnia, but do not seem to mitigate the impact of racial discrimination.
很少有研究探讨退伍军人中失眠发生率及相关因素的种族/民族差异。本研究比较了不同种族/民族背景退伍军人的失眠发生率及对睡眠治疗的兴趣。与3P模型一致，我们将种族歧视作为失眠的预测因素进行测试，分别将创伤后应激障碍症状和恋爱伴侣作为该关联的持续和保护调节因素。共有325名退伍军人（N = 236名有色人种退伍军人；12%为亚裔，36%为黑人，14%为西班牙裔/拉丁裔）从偏远地区在线完成了问卷调查。使用描述性统计来比较不同种族/民族群体的模式。采用线性回归来测试种族歧视与失眠严重程度之间关联的调节因素。总体而言，68%的参与者失眠筛查呈阳性：90%的亚裔；79%的西班牙裔/拉丁裔；65%的黑人；58%的白人参与者。其中，74%表示对睡眠治疗感兴趣，76%有伴侣的人表示有兴趣让伴侣参与治疗。种族歧视和创伤后应激障碍与更严重的失眠相关，而恋爱伴侣与较轻的失眠相关。只有创伤后应激障碍调节了种族歧视与失眠严重程度之间的关联。亚裔和西班牙裔/拉丁裔参与者的失眠发生率最高，但这些群体对睡眠治疗感兴趣的可能性最小。种族歧视可能会加剧退伍军人的失眠症状，但仅在那些在创伤后应激障碍背景下尚未出现睡眠障碍的人中如此。恋爱伴侣可能是失眠的一个保护因素，但似乎并不能减轻种族歧视的影响。
