Singh Rupsha, Villalobos Kevin, Cohen Jeffrey H, Maleku Arati, Pyakurel Sudarshan, Suzuki Taku, Raut Shambika, Troyer Mark, Jackson Chandra L, Montiel Ishino Francisco Alejandro
Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA.
Epidemiology Branch, Division of Intramural Research, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA.
Sleep Health. 2024 Dec;10(6):722-730. doi: 10.1016/j.sleh.2024.08.006. Epub 2024 Sep 20.
We investigated profiles of community support and challenges in relation to insomnia symptoms among the Bhutanese living in the United States.
Using data from the pilot Bhutanese Community of Central Ohio Health Study (N = 495; 51.5% men, 69.8% aged 18-44years), we used latent class analysis to identify distinct profiles of neighborhood social cohesion, social support, and community challenges (e.g., limited access to healthcare services and transportation, crime and safety issues, substance use, intimate partner violence) and their associations with insomnia symptoms. Insomnia symptoms were self-reported as difficulty falling and staying asleep and dichotomized as "not at all" vs. "some to always." Identified classes/profiles were further differentiated by self-reported sociodemographic, socioeconomic, health, acculturative, and discrimination factors.
Latent class analysis revealed four distinct classes/profiles. The High Cohesion (class 1) profile (30.1% of sample) had the lowest likelihood of insomnia symptoms at 6.5%, followed by class 2 or High Support (23.6%) with a 15.3% likelihood. Class 3 or High Challenges profile (11.5%) had a moderate likelihood of insomnia symptoms at 49%. Class 4 or the Low Cohesion/Support profile (34.7%) had a 100% likelihood of reporting insomnia symptoms. Class 4 when compared to class 1 was more likely to report cardiometabolic conditions, experiences of everyday discrimination, limited English linguistic proficiency, and not using telehealth.
Community social cohesion and support may play an important role in mitigating insomnia symptoms among Bhutanese refugees. Further investigations are warranted.
我们调查了居住在美国的不丹人社区支持情况以及与失眠症状相关的挑战。
利用俄亥俄州中部不丹人社区健康研究试点的数据(N = 495;51.5%为男性,69.8%年龄在18 - 44岁),我们使用潜在类别分析来识别邻里社会凝聚力、社会支持和社区挑战(如医疗服务和交通不便、犯罪与安全问题、物质使用、亲密伴侣暴力)的不同概况及其与失眠症状的关联。失眠症状通过自我报告入睡和保持睡眠困难情况,并分为“完全没有”与“有时至总是有”。通过自我报告的社会人口学、社会经济、健康、文化适应和歧视因素进一步区分所识别的类别/概况。
潜在类别分析揭示了四个不同的类别/概况。高凝聚力(第1类)概况(占样本的30.1%)出现失眠症状的可能性最低,为6.5%,其次是第2类或高支持(23.6%),可能性为15.3%。第3类或高挑战概况(11.5%)出现失眠症状的可能性中等,为49%。第4类或低凝聚力/支持概况(34.7%)报告失眠症状的可能性为100%。与第1类相比,第4类更有可能报告心血管代谢疾病、日常歧视经历、英语语言能力有限以及未使用远程医疗。
社区社会凝聚力和支持可能在减轻不丹难民的失眠症状方面发挥重要作用。有必要进行进一步调查。