0930 What explains high self-reports of poor sleep quality in Native Hawaiian/Pacific Islanders?

Abstract

Abstract Introduction High rates of poor sleep quality have been reported among patients of Native Hawaiian/Pacific Islander (NHPI) race. Unrestful sleep might be attributable to short sleep times or to elevated rates of obstructive sleep apnea among NHPIs. We aimed to evaluate factors associated with self-reported poor sleep quality among NHPIs in a nationwide, representative community sample. Methods Using the 2014 National Health Interview Survey (NHIS), we used logistic regression to model the odds of individuals reporting that they did not awake feeling rested at least two out of the prior seven days. NHPIs from the NHPI-NHIS and non-NHPIs from the general sample were compared. Age, sex, BMI, smoking status, report of heavy drinking, employment status, marital status, and reported average hours of sleep time were evaluated in terms of their effects on self-reported sleep quality. Results Data from 36,697 non-NHPI and 2,590 NHPI individuals was available for analysis. There were significant differences in age, BMI, marital and current employment status between NHPIs vs. non-NHPIs. NHPI patients reported less sleep (mean 6.86±1.41 hours) in contrast to non-NHPIs (mean 7.12±1.42 hours) (P< 0.001). NHPIs were more likely to report two or more days awakening not feeling rested (Odds Ratio (OR) 1.22, 95% confidence interval (95CI) 1.12–1.32) as compared to non-NHPIs. After adjusting for demographics, BMI, alcohol, smoking, and marital and employment status, the relationship persisted (OR 1.17, 95CI 1.07-1.28). When additionally controlling for sleep time, which was strongly associated with the likelihood of awakening unrested (OR 3.1 95CI 2.9-3.2 for six or fewer average hours of sleep), there was no significant relationship between race and likelihood of awakening unrested (OR 1.02, 95CI 0.93-1.13). Findings were similar when evaluating different thresholds of unrestful nights per week. Conclusion NHPIs are more likely to awake feeling unrested than non-NHPIs. The higher rate of unrestful sleep is associated with higher reports of short (6 hours or less) sleep time. Therefore, future research to improve sleep quality in NHPIs should also investigate the cultural and social factors leading to short sleep time. Support (if any) BWL: NIH Ruth L. Kirschstein National Research Service Award 5T32HL105321 and the ATS ASPIRE Fellowship