Abstract
Introduction: Sleep disorders and short sleep duration have been associated with increased incidence of stroke. Despite evidence of racial/ethnic disparities in stroke, few studies have examined differences in sleep duration and disturbances by race/ethnicity among stroke survivors. Methods: Data on self-reported sleep duration and sleep disturbances came from the baseline interview of the Discharge Educational Strategies for Reduction of Vascular Events (DESERVE) study, a randomized clinical trial of a skills-based intervention to reduce vascular risk in a multi-ethnic cohort of 552 mild stroke/TIA patients. Sleep duration was defined as average hours of sleep per night in the past month, and sleep disturbances were measured using the Medical Outcomes Study (MOS) Sleep Disturbances Index, which ranges from 0-100, with higher scores indicating more frequent disturbances. Differences in sleep duration and disturbance score by race/ethnicity were assessed using t-tests and multiple linear regression adjusted for age, sex, education, current smoking and alcohol consumption, body mass index, marital/cohabitation status, number of household members, and depression score. Results: Overall, patients reported an average of 6.37 hours of sleep per night, and mean Sleep Disturbance Index score was 35.8. Mean sleep duration was significantly lower among non-Hispanic blacks than non-Hispanic whites (6.12 vs. 6.69 hours, p=0.004). Mean disturbance score was significantly higher among both non-Hispanic blacks and Hispanics compared to non-Hispanic whites (35.7 vs. 27.8, p=0.013 and 42.6 vs. 27.8, p<0.001, respectively). In adjusted models, sleep duration was no longer significantly associated with race/ethnicity. However, mean sleep disturbance scores remained significantly greater among non-Hispanic blacks and Hispanics compared to non-Hispanic whites (β=11.6, p=0.006, and β=8.8, p=0.039, respectively). Conclusion: Sleep disturbances were more frequent among Hispanics and non-Hispanic blacks, two populations that are disproportionately affected by stroke. Further research is warranted to understand the role differences in sleep may play in racial/ethnic disparities in stroke.
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