Cavaillès Clémence, Stone Katie L, Leng Yue, Peltz Carrie, Yaffe Kristine
Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, California, USA.
Department of Research Institute, California Pacific Medical Center, San Francisco, California, USA.
medRxiv. 2025 Mar 13:2025.03.12.25323859. doi: 10.1101/2025.03.12.25323859.
Research on sleep disparities across different sociodemographic groups is limited and often yields inconsistent findings. We aimed to examine differences in objective sleep measures by race and ethnicity, sex, and age within a diverse cohort of community-dwelling older adults.
We analyzed cross-sectional data from 838 participants aged ≥50 years in the Dormir Study (2020-2024). Sleep metrics, including sleep duration, sleep efficiency, wake after sleep onset (WASO), and sleep fragmentation index (SFI), were derived from 7-day wrist actigraphy. Race and ethnicity (Black; Mexican American [MA]; Non-Hispanic White [NHW]), sex, and age (<65; ≥65 years) were self-reported. We compared sleep metrics across sociodemographic groups and assessed their multivariable associations using linear, logistic, and multinomial regression models.
We studied 190 (22.7%) Black, 282 (33.6%) MA, and 366 (43.7%) NHW Dormir participants, with a mean age of 66.7 ±8.4 years, and 64.8% women. Compared to NHW participants, Black and MA participants had shorter mean sleep duration (Black: 7.1 ±1.2 hours; MA: 7.1 ±1.1 hours; NHW: 7.5 ±1.1 hours; p<0.0001), lower median sleep efficiency (Black: 87.2%; MA: 87.8%; NHW: 90.6%; p<0.0001), longer median WASO (Black: 61.2 minutes; MA: 56.7 minutes; NHW: 44.4 minutes; p<0.0001), and higher mean SFI (Black: 32.0 ±11.0%; MA: 27.3 ±9.7%; NHW: 24.0 ±9.0%; p<0.0001). Compared to men, women had longer mean sleep duration (women: 7.4 ±1.1 hours; men: 7.1 ±1.2 hours; p=0.0004) and lower mean SFI (women: 25.9 ±8.8%; men: 28.9 ±12.1%; p=0.0001). Older participants had longer mean sleep duration (old: 7.4 ±1.1 hours; young: 7.1 ±1.1 hours; p<0.0001), higher median sleep efficiency (old: 89.8%; young: 87.7%; p<0.0001), shorter median WASO (old: 48.5 minutes; young: 56.8 minutes; p<0.0001), and lower mean SFI (old: 26.1 ±10.2%; young: 28.1 ±10.2%; p=0.007). After adjusting for socioeconomic and behavioral factors, comorbidities, and sleep medications, findings were consistent except for age group comparisons in which differences were no longer significant.
Our findings demonstrate significant variations in objective sleep measures across sociodemographic groups, with non-White participants and men experiencing poorer sleep quality. These disparities may contribute to health inequalities, emphasizing the need for targeted interventions to support at-risk populations.
关于不同社会人口学群体睡眠差异的研究有限，且结果往往不一致。我们旨在研究在一个多样化的社区居住老年人队列中，种族和族裔、性别以及年龄在客观睡眠指标上的差异。
我们分析了多明尔研究（2020 - 2024年）中838名年龄≥50岁参与者的横断面数据。睡眠指标，包括睡眠时间、睡眠效率、睡眠后觉醒时间（WASO）和睡眠碎片化指数（SFI），均来自7天的手腕活动记录仪监测。种族和族裔（黑人；墨西哥裔美国人[MA]；非西班牙裔白人[NHW]）、性别以及年龄（<65岁；≥65岁）通过自我报告获取。我们比较了不同社会人口学群体的睡眠指标，并使用线性、逻辑和多项回归模型评估它们的多变量关联。
我们研究了190名（22.7%）黑人、282名（33.6%）墨西哥裔美国人和366名（43.7%）非西班牙裔白人多明尔参与者，平均年龄为66.7±8.4岁，女性占64.8%。与非西班牙裔白人参与者相比，黑人和墨西哥裔美国人的平均睡眠时间更短（黑人：7.1±1.2小时；墨西哥裔美国人：7.1±1.1小时；非西班牙裔白人：7.5±1.1小时；p<0.0001），睡眠效率中位数更低（黑人：87.2%；墨西哥裔美国人：87.8%；非西班牙裔白人：90.6%；p<0.0001），WASO中位数更长（黑人：61.2分钟；墨西哥裔美国人：56.7分钟；非西班牙裔白人：44.4分钟；p<0.0001），平均SFI更高（黑人：32.0±11.0%；墨西哥裔美国人：27.3±9.7%；非西班牙裔白人：24.0±9.0%；p<0.0001）。与男性相比，女性的平均睡眠时间更长（女性：7.4±1.1小时；男性：7.1±1.2小时；p = 0.0004），平均SFI更低（女性：25.9±8.8%；男性：28.9±12.1%；p = 0.0001）。年龄较大的参与者平均睡眠时间更长（老年人：7.4±1.1小时；年轻人：7.1±1.1小时；p<0.0001），睡眠效率中位数更高（老年人：89.8%；年轻人：87.7%；p<0.0001），WASO中位数更短（老年人：48.5分钟；年轻人：56.8分钟；p<0.0001），平均SFI更低（老年人：26.1±10.2%；年轻人：28.1±10.2%；p = 0.007）。在调整社会经济和行为因素、合并症以及睡眠药物后，除年龄组比较差异不再显著外，其他结果保持一致。
我们的研究结果表明，不同社会人口学群体在客观睡眠指标上存在显著差异，非白人参与者和男性的睡眠质量较差。这些差异可能导致健康不平等，强调了需要有针对性的干预措施来支持高危人群。
