Department of Epidemiology Rollins School of Public Health, Emory University Atlanta GA.
Department of Biostatistics and Informatics Rollins School of Public Health, Emory University Atlanta GA.
J Am Heart Assoc. 2024 Oct;13(19):e033844. doi: 10.1161/JAHA.123.033844. Epub 2024 Sep 30.
Discrimination may contribute to sleep health disparities among women, yet limited research has investigated the association between discrimination and insomnia with short sleep.
Among a racially and ethnically diverse sample of women (N=25 920; mean age, 72.2±6.1 years), we investigated the relationship of discrimination with insomnia symptoms and sleep duration. Poisson models with robust variance were fit to examine discrimination with insomnia, sleep duration (short <7 hours or long >9 hours versus recommended 7-9 hours), and insomnia short sleep phenotype adjusted for covariates. Insomnia symptoms, short and long sleep, and high discrimination were reported by 53%, 11%, 15%, and 40% of women, respectively. Women reporting high versus low discrimination were more likely to report insomnia, short sleep, and insomnia short sleep phenotype (insomnia: adjusted prevalence ratio, 1.15 [95% CI, 1.13-1.18]; short sleep: adjusted prevalence ratio, 1.24 [95% CI, 1.16-1.34]; insomnia short sleep phenotype: adjusted prevalence ratio, 1.45 [95% CI, 1.31-1.61]). In exploratory analyses, the association between discrimination and insomnia symptoms was present among Asian and White women, whereas the association between discrimination and sleep duration was among Hispanic (long sleep) and White (short sleep) women. Further, the association between discrimination and insomnia symptoms was more pronounced among those with less than a bachelor's degree, whereas women with a bachelor's degree or higher were less vulnerable to the association between discrimination and long sleep.
Discrimination was associated with insomnia and short sleep, a more severe phenotype for adverse cardiovascular health. Discrimination may be a target for reducing sleep problems among older women.
歧视可能导致女性的睡眠健康状况存在差异，但很少有研究调查歧视与失眠和睡眠不足之间的关系。
在一个种族和民族多样化的女性样本中（N=25920；平均年龄 72.2±6.1 岁），我们研究了歧视与失眠症状和睡眠时间之间的关系。使用具有稳健方差的泊松模型来检查歧视与失眠、睡眠时间（<7 小时或>9 小时的短睡眠时间或推荐的 7-9 小时睡眠时间）以及调整了协变量的失眠短睡眠表型之间的关系。分别有 53%、11%、15%和 40%的女性报告有失眠症状、短睡眠时间、长睡眠时间和高歧视。与低歧视相比，报告高歧视的女性更有可能报告失眠、短睡眠和失眠短睡眠表型（失眠：调整后的患病率比，1.15[95%置信区间，1.13-1.18]；短睡眠：调整后的患病率比，1.24[95%置信区间，1.16-1.34]；失眠短睡眠表型：调整后的患病率比，1.45[95%置信区间，1.31-1.61]）。在探索性分析中，歧视与失眠症状之间的关联存在于亚裔和白人女性中，而歧视与睡眠时间之间的关联存在于西班牙裔（长睡眠）和白人（短睡眠）女性中。此外，歧视与失眠症状之间的关联在那些没有学士学位的女性中更为明显，而那些拥有学士学位或更高学历的女性则不太容易受到歧视与长睡眠之间关联的影响。
歧视与失眠和睡眠不足有关，这是对心血管健康更不利的表型。歧视可能是减少老年女性睡眠问题的目标。
