Race and Economic Status Tied to Sleep and Overall Health

Sleep problems and chronic disease odds found to be higher in minorities and people in lower socioeconomic group

(RxWiki News) Poor sleep has been linked to chronic disease and obesity. Race and socioeconomic status also have been linked to poor health. It is possible that all these factors are connected. 

A recent study found that racial minorities and people of lower socioeconomic status were more likely to experience sleep problems and chronic disease compared to white people and people of higher socioeconomic status.

The researchers discovered that race and socioeconomic status were associated with the poor health outcomes, and that sleep issues were not a huge factor in that association.

"Tell a doctor if you aren't sleeping well."

The lead author of this study was Rebecca S. Piccolo, ScM, from the Department of Epidemiology of New England Research Institutes, Inc. in New Haven, Connecticut.

The study included 4,415 residents of Boston, Massachusetts who took part in a previous study called the Boston Area Community Health (BACH) Survey. All the participants were between the ages of 30 and 79 years old.

There were 1,610 men and 2,535 women. Roughly one-third of the participants were black, one-third were Hispanic and one-third were white.

Participants were initially interviewed for the BACH study between 2002 and 2005, and then interviewed again for follow-up interviews between 2006 and 2010. The average follow-up time was 4.8 years.

The researchers asked the participants to self-report both race and ethnicity. Participants' socioeconomic status was determined by looking at the standardized levels of education and income in the Northeast and categorized into one of three socioeconomic status (SES) groups: upper 1/4 SES, middle 1/2 SES or lower 1/4 SES.

Then, only the men were asked to self-report on whether or not they experienced sleep restriction. The researchers defined sleep restriction as having five or less hours of sleep per night.

The whole participant population self-reported whether or not they regularly experienced restless sleep.

The findings showed that 331 men (18 percent of the men) reported experiencing restricted sleep.

The researchers found that 32 percent of all the black men and 20 percent of all the Hispanic men reported regular sleep restriction, compared to 13 percent of all the white men.

Of the men in the lower SES group, 28 percent reported sleep restriction, while 20 percent of the men in the middle SES group and 8 percent of the men in the upper SES group reported sleep restriction.

A total of 24 percent of all the obese men, 17 percent of all the overweight men and 13 percent of all the men of normal weight reported having regular sleep restriction.

In addition, 31 percent of all the men who had fair or poor health reported sleep restriction, compared to 16 percent of all the men who had good or excellent health. 

The findings also revealed that of all the men with diabetes at baseline, 27 percent had sleep restriction group. Of all the men with high blood pressure at baseline, 26 percent reported sleep restriction; and of all the men who had heart disease at baseline, 27 percent reported experiencing regular sleep restriction. 

The researchers found that 38 percent of the total study population (both men and women) reported experiencing regular restless sleep. Out of the all the black participants, 43 percent reported regular restless sleep, compared to 43 percent of all the Hispanic participants and 35 percent of all the white participants.

Almost half of the all the participants in the lower SES group, 38 percent of the whole middle SES group and 27 percent of the total upper SES group reported regular restless sleep. The researchers also found that 44 percent of all obese participants reported restless sleep versus 36 percent of all overweight participants and 32 percent of all participants of normal weight. 

Fifty-six percent of all participants with either fair or poor health reported issues with restless sleep compared to 35 percent of all participants with good or excellent health. Lastly, 59 percent of all baseline diabetic participants, 45 percent of all participants with high blood pressure at baseline and 48 percent of all participants with heart disease at baseline reported experiencing regular restless sleep.

The researchers then adjusted for factors such as age, sex, marital status, alcohol use, level of physical activity, smoking status and antidepressant use.

It was determined that restless sleep was associated with 66 percent increased odds of developing obesisty by follow-up compared to those who did not experience sleep issues.

The participants in the lower SES group were found to have 3.84 times increased odds of developing diabetes by follow-up, and the middle SES group had 2.31 times increased odds compared to the participants in the upper SES group.

Having lower SES was associated with a 76 percent increase in the odds of developing heart disease at follow-up compared to having upper SES. In addition, the lower SES group had a 90 percent increase in the odds of developing high blood pressure compared to the upper SES group.

The researchers concluded that racial minorities and those in the lower SES group were significantly more likely to experience sleep issues compared to the white participants and the upper SES group. However, sleep problems were not found to be significantly associated with the incidence of chronic disease.

Racial differences and lower SES status were the main predictors of poor health outcomes, and the level of sleep issues were not found to make much of a difference in these race and SES disparities.

The authors noted that the main limitation of this study was that only the men reported on sleep restriction.

This study was published in December in Ethnicity and Disease.

The National Institute on Minority Health and Health Disparities and the National Institute of Diabetes and Digestive and Kidney Disorders provided funding.

Review Date: 
December 23, 2013