Acculturation and sleep among a multiethnic sample of women: the Study of Women's Health Across the Nation (SWAN)

• Published in: Sleep (New York, N.Y.) N.Y.), 2014-02, Vol.37 (2), p.309-317
• Main Authors: Hale, Lauren, Troxel, Wendy M, Kravitz, Howard M, Hall, Martica H, Matthews, Karen A
• Format: Article
• Language: English
• Subjects: Acculturation; Adult; Asian Continental Ancestry Group - psychology; Asian Continental Ancestry Group - statistics & numerical data; China - ethnology; Cross-Sectional Studies; Emigrants and Immigrants - psychology; Emigrants and Immigrants - statistics & numerical data; Ethnic Groups - psychology; Ethnic Groups - statistics & numerical data; European Continental Ancestry Group - psychology; European Continental Ancestry Group - statistics & numerical data; Female; Hispanic Americans - psychology; Hispanic Americans - statistics & numerical data; Humans; Immigration Status, Acculturation, and Sleep Complaints; Japan - ethnology; Language; Logistic Models; Middle Aged; Sleep - physiology; Sleep Wake Disorders - epidemiology; Sleep Wake Disorders - ethnology; Sleep Wake Disorders - psychology; Surveys and Questionnaires; United States - epidemiology; United States - ethnology; Women's Health - ethnology; Women's Health - statistics & numerical data
• ISSN: 0161-8105; 1550-9109
• DOI: 10.5665/sleep.3404

Mexican immigrants to the United States report longer sleep duration and fewer sleep complaints than their US-born counterparts. To investigate whether this effect extends to other immigrant groups, we examined whether the prevalence of self-reported sleep complaints is higher among US-born Hispanic/Latina, Chinese, and Japanese immigrant women compared to their first-generation immigrant ethnic counterparts as well as to US-born whites. We examined whether these associations persisted after adjusting for sociodemographic and health characteristics and whether acculturation mediated the effects. Cross-sectional observational study. Multisite study in Oakland, CA; Los Angeles, CA; and Newark, NJ. Hispanic/Latina (n = 196), Chinese (n = 228), Japanese (n = 271) and non-Hispanic white (n = 485) women (mean age = 46 y, range 42-52 y) participating in the Study of Women's Health Across the Nation (SWAN); 410 or 59.0% of the nonwhites were first-generation immigrants. None. Questionnaires were used to assess sleep complaints, race/ethnicity, immigrant status, language acculturation (use of English language), and sociodemographic and health variables. Approximately 25% of first-generation immigrant women reported sleep complaints compared to 37% of those who were US-born nonwhites and 42% of US-born whites. Multivariable adjusted logistic regression analyses showed that US-born nonwhites had higher odds of reporting any sleep complaints (odds ratio = 2.1, 95% confidence interval [CI] 1.5-3.0), compared to first-generation immigrants. Women with higher levels of language acculturation had greater odds of reporting any sleep complaint compared to those with less language acculturation. Adjustment for language acculturation mediated 40.4% (95% CI 28.5-69.8) of the association between immigrant status and any sleep complaint. When results were stratified by race/ethnicity, significant mediation effects of acculturation were only found for Hispanic/Latina and Japanese women, but not for Chinese women. US-born Hispanic/Latina, Chinese, and Japanese immigrants were more likely to report sleep complaints than their first-generation ethnic counterparts, a finding largely explained by language acculturation and unmeasured factors associated with language acculturation.