Most work on ethnicity tends to focus on daytime health rather than how aspects of ethnicity affect nighttime functioning. The current study examined how discrimination and ethnic identity relate to sleep architecture and fatigue in 37 African Americans and 56 Caucasian Americans. The authors conducted sleep monitoring with standard polysomnography. African Americans had less slow-wave sleep and reported more physical fatigue than did Caucasian Americans (ps < .05). The authors conducted path analyses to examine relationships between ethnic identity, perceived discrimination, sleep, and fatigue. Perceived discrimination mediated ethnic differences in Stage 4 sleep and physical fatigue. Individuals who reported experiencing more discrimination had less Stage 4 sleep and reported experiencing greater physical fatigue (ps < .05). Although ethnic identity did not mediate ethnic differences in sleep latency, there was a significant relationship between ethnic identity and sleep latency, indicating that individuals who felt more connected to their ethnic group had more difficulty falling asleep while in the hospital (p < .05). These observations suggest that the effects of stress related to one's ethnic group membership carry over into sleep.

The extent to which men believe that cancer is inconsistent with their masculinity exacerbates declines in prostate-related functioning following cancer treatment. CMT likely shapes coping responses and negatively affects the efficacy of emotion-directed coping. Emotion-regulating coping processes, particularly the ability to process cancer-related emotions, appears to be one pathway through which gender role affects recovery from prostate cancer.

Background-Sleep problems are a common complaint in cancer patients that has been understudied.

Individuals with underlying inflammation present with a high prevalence of non-specific comorbid symptoms including sleep disturbance and fatigue. However, the association between cellular expression of proinflammatory cytokines, alterations of sleep depth and daytime fatigue has not been concurrently examined. In healthy adults (24 -61 years old), evening levels of monocyte intracellular proinflammatory cytokine production were assessed prior to evaluation of polysomonographic sleep and measures of fatigue the following day. Stimulated monocyte production of interleukin-6 (IL-6), but not tumor necrosis factor α (TNF-α), was negatively associated with slow wave sleep (ΔR 2 =.17, p=.029). In contrast, stimulated monocyte production of IL-6 was positively associated with rapid-eye movement (REM) sleep duration during the first sleep cycle (ΔR 2 = .26, p<.01). Moreover, evening stimulated production of IL-6 was associated with fatigue the following day (ΔR 2 = .17, p=.05). Mediation analyses showed that slow wave sleep, but not REM sleep duration, mediated the relationship between evening levels of IL-6 production and daytime fatigue. These results indicate that increases in stimulated monocyte production of IL6 may be associated with changes in sleep architecture with decreases in slow wave sleep and increases in REM sleep duration. Relative loss of slow wave sleep may be one pathway through which cellular inflammation leads to daytime fatigue.

Abstract-Several studies have demonstrated that blacks have heightened pressor sensitivity in response to the ␣-agonist, phenylephrine. However, studies examining whether psychosocial factors contribute to this difference are scarce. We examined the effects of job strain on pressor sensitivity in 76 whites and 46 blacks who were enrolled in a study of stress, sleep, and blood pressure. Responses to phenylephrine were examined at an inpatient clinical research center. After a 3-minute baseline period, a 100-microgram phenylephrine bolus was administered to participants intravenously. To measure catecholamines, 24-hour urine samples were also collected from participants. There was a significant relationship between job strain and pressor sensitivity, such that individuals with low decisional control and high job demands experienced a greater increase in diastolic pressure after receiving phenylephrine. Low decisional control was also associated with decreased baroreflex sensitivity. There was an interaction between ethnicity and job control on blood pressure responses to phenylephrine and on 24-hour urinary norepinephrine levels. Blacks who perceived less control experienced a greater increase in diastolic pressure after receiving phenylephrine and had elevated norepinephrine levels. These findings suggest possible mechanisms by which job strain may be associated with cardiovascular disease.

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Objective Emotion-regulating coping is associated with improvements in psychological and physical health outcomes. Yet in the context of prostate cancer-related stressors, limited research has characterized associations of emotion-regulating coping processes (emotional expression, emotional processing) and inflammatory processes that are related to disease risk. This investigation examined the relation of Emotional Approach Coping (EAC) with markers of inflammation to test the hypothesis that higher EAC scores at study entry (T1) would be associated with lower proinflammatory markers four months later (T2), specifically sTNF-RII, CRP, and IL-6. Methods Forty-one men (M age=66.62 years; SD=9.62) who had undergone radical prostatectomy or radiation therapy for localized prostate cancer within two years completed questionnaires, including assessments of EAC, at T1, and provided blood samples for immune assessments at T2. Results When controlling for relevant biobehavioral controls, emotional processing predicted lower IL-6 (B=−.66, p<.01), sTNF-RII (B=−.43, p<.05), and CRP (B=−.43, p<.10), whereas emotional expression was significantly associated with higher levels of sTNF-RII (B=.55, p<.05). Associations of emotional expression and IL-6 (B=.38, p<.10), and CRP (B=.44, p<.10) approached significance. Probing interactions of emotional processing and expression (though only approaching significance) suggested that expression of emotion is associated with higher inflammation (CRP and sTNF-RII) only in the context of low emotional processing. Conclusions Attempts at emotion regulation via emotional processing appear to modulate inflammatory processes. Understanding, making meaning of, and working through emotional experience may be a promising target of intervention to reduce inflammation with potential effects on psychological and cancer outcomes in men with prostate cancer.

These findings suggest that psychological factors may be important in understanding ethnic differences in nocturnal BP decline.