Abstract P520: Sleep Duration and Quality Associated With Behavioral Cardiometabolic Health in Israel: Jewish / Arab Ethnic Differences

Abstract

Introduction: The role of sleep health in global cardiometabolic disparities has not been sufficiently explored as a modifiable factor. Israeli Jews and Arabs share national and cultural experiences, but differ with respect to important historical, socio-economic, and cultural aspects. Hypothesis: Jewish/Arab Israeli disparities in cardiometabolic health may be partially explained by differences in sleep. Methods: 7,230 Israeli individuals (N=5880 Jews and N=1350 Arabs) responded to the 2017 Israeli Bureau of Statistics population-based survey of households. Behavioral risk factors included poor diet (<4 servings/day of vegetables), sedentary lifestyle (no exercise within the past 3 months), smoking, and obesity (based on self-reported height and weight). Sleep variables included sleep duration (<=5, 6, 7, 8 [reference], or >=9 hours) and sleep difficulty in the past month (none [reference], mild, moderate, or severe). Covariates included age and sex. Results: Israeli Arabs were more likely to be smokers (OR=1.41), sedentary (OR=1.44), obese (OR=1.73), and consume <4 vegetable servings (OR=3.23). In adjusted analyses of sleep duration, smoking was associated with <=5h (OR=1.49, 95%CI [1.23,1.80], p<0.0005) and >=9h (OR=1.33, 95% CI [1.02,1.72], p=0.035), and it was associated with moderate (OR=1.45, 95%CI [1.21,1.75], p<0.0005) and severe (OR=1.57, 95%CI [1.33,1.86], p<0.0005) sleep difficulties. A significant duration-by-ethnicity interaction was observed (p=0.003). Stratified analyses showed that smoking was associated with <=5h and 6h and relationships were stronger in Israeli Arabs. Insufficient vegetable consumption was associated with moderate (OR=1.25, 95%CI [1.04,1.52], p=0.02) and severe (OR=1.32, 95%CI [1.12,1.57], p=0.001) sleep difficulties. A significant duration-by-ethnicity interaction was observed (p=0.02). In stratified analyses, no relationships were seen among Israeli Jews, but among Israeli Arabs, insufficient vegetable consumption was negatively associated with shorter sleep. Sedentary lifestyle was associated with severe sleep difficulties (OR=1.31, 95%CI [1.04,1.65], p=0.02). No interactions were found. Obesity was associated with <=5h (OR=1.36, 95%CI [1.10,1.68], p=0.004) and severe sleep difficulties (OR=1.40, 95%CI [1.17,1.67], p<0.0005). A significant duration-by-ethnicity interaction was found. In stratified analyses, among Israeli Jews, obesity was associated with 7h sleep duration, but among Israeli Arabs, obesity was associated with <=5h, 6h, and >=9h. Conclusions: Behavioral cardiometabolic health factors were associated with poor sleep health, but these relationships were generally stronger among Israeli Arabs. Sleep health may be a fruitful intervention target to reduce disparities.