Introduction The COVID-19 pandemic has deteriorated sleep health in the United States (U.S.) and worldwide. Most studies that have examined the association between COVID-19 and sleep outcomes have used a non-probability sampling with potential sampling bias and limited generalizability. We examined the association between diagnosed COVID-19 and sleep health in a large representative sample of civilian adults aged ≥18 years in the U.S. Methods This study was based on data from the 2020 National Health Interview Survey (NHIS) of adults (n=17,636). Sleep health was captured by self-reported sleep quantity [(very short (≤ 4 hours), short (5-6 hours), healthy (7-8 hours), or long (≥9 hours)] and sleep complaints (trouble falling and staying asleep; with responses ranging from never to every day) in the past 30 days. To account for correlated residuals among the endogenous sleep outcomes, generalized structural equation modeling (GSEM) was conducted with COVID-19 diagnosis as the predictor of interest. Other covariates (age, sex, race/ethnicity, education, employment, poverty level, marital status, birthplace, health insurance, region of residence, metropolitan areas, number of children and adults in the household, obesity, and sleep medication) were included in the models. NHIS complex probability sampling design was accounted for in descriptive and GSEM analyses. Results About 4.2% of adults had a positive COVID-19 diagnosis. Among them, 3.1% had very short sleep, 24.2% had short sleep, 59.9% had healthy sleep, and 12.8% had long sleep; 37.0% had trouble falling some days, 10.9% most days, and 6.5% every day; and 33.7% had trouble staying asleep some days, 13.9% most days, and 6.6% every day. Findings from GSEM revealed that a history of COVID-19 almost doubled the odds of having short sleep (OR: 1.9; 95% CI: 1.1-3.4; p=0.032). No significant associations were found between COVID-19 and the other sleep outcomes. Conclusion Individuals with a COVID-19 diagnosis were more likely to report very short sleep, although they did not exhibit a greater likelihood of reporting more sleep complaints. Further research using longitudinal national data and examining environmental factors are needed to determine causality. Support (If Any) NIH R01HL142066, R01HL095799, RO1MD004113, R01HL152453, R25HL105444
Introduction One in three American adults are sleep deprived in the United States (US). Racial/ethnic minorities are more likely to experience shorter sleep duration than are whites. Light exposure is associated with sleep duration. However, whether this association is independent of individuals’ race/ethnicity has not been studied in a nationally representative sample of the US adult population. We examined associations between ambient light exposure and sleep duration and between race/ethnicity and sleep duration. We also assessed whether associations between light exposure and sleep duration are independent of participants’ race/ethnicity. Methods We used data from the National Health and Nutrition Examination Survey (n=4,277 adults; 2013-2014). Participants (≥ 18 years old) wore an actigraph that collected 24-hour sleep/wake and light data for 7 consecutive days. Objective measurements in our analyses included sleep duration (valid minutes) and light exposure (lux). To determine the associations between light exposure and sleep duration, a weighted mixed-effects linear model was estimated controlling for age, sex, family income to poverty ratio, education, employment, marital status, homeownership status, birthplace, household size, vitamin D, smoking, physical activity, sedentary lifestyle, health status, body mass index, depression, chronic conditions, and time in days. A product term between lux and race/ethnicity was included in a second regression model. Results Participants had a mean sleep duration of 468.2 minutes. On average, White adults had the longest sleep duration (mean=478.8), followed by other/multiple races (mean=458.6), Asians (mean=449.1); Blacks (mean=445.0), and Hispanics (mean=444.7). Overall, light exposure was negatively associated with sleep duration (= -0.08 lux; p<0.001). Black slept significantly less than did Whites (= -37.1 p<0.001) followed by Asians ( = -26.5; p<0.01) and Hispanics (= -24.6; p<0.01). The association between light exposure and sleep duration did not significantly differ across all race/ethnic groupings, except for Blacks (= -0.05; p<0.01). Conclusion To our knowledge, this is the first study that used national data to assess racial/ethnic disparities in objectively measured light exposure. Future research is needed to shed more light on racial/ethnic disparities in the light-exposure-sleep-duration link. Support (If Any) R01HL142066, R01HL095799, RO1MD004113, R01HL152453, R25HL105444
Introduction Poor sleep, which has numerous deleterious effects, is one of the most common health complaints among college students. Both race/ethnicity and sex are associated with poor sleep outcomes, with Black college women potentially having higher risk. The college experience is often associated with an increase in stress, as well as drastic shifts in lifestyle and sleep patterns. Research indicates that college students report cannabis use enables them to cope with life stressors and negative emotions and is often used as a sleep aid. The use of cannabis as a to cope may lead to more chronic cannabis use, and the development of Cannabis Use Disorder (CUD), which is most prevalent in individuals aged 18-25. Therefore, this study examined the influence of CUD symptomatology on sleep among Black female college students. Methods Participants included 200 Black/African American women (age range: 18-25 years) attending a Historically Black College/University. Each participant completed an Qualtrics online survey including assessment of DSM-5 CUD criteria, and validated measures of sleep quality (Pittsburgh Sleep Quality Index [PSQI]) and perceived stress (Perceived Stress Scale [PSS]). Results 11.5% of the sample met criteria for CUD. There were no significant differences between the CUD and non-CUD groups in perceived stress, however, all participants endorsed moderate stress levels (M=19.51, SD=5.33). Additionally, all participant’s PSQI scores met criteria for impaired sleep (score >5). [MOU1] [TAD2] T-test analyses indicate that the CUD subgroup reported poorer sleep quality (M=9.04, SD=3.69 vs M=7.07, SD=3.28), more sleep disturbances (M=1.52, SD=0.59 vs M=1.15, SD=0.74), and longer sleep latency (M=37.70, SD=25.28 vs M=25.92, SD=23.95), than the non-CUD group (all p<.05). Conclusion Black/African American female college students who met criteria for CUD reported more sleep disturbances, longer sleep latencies, and poorer overall sleep quality. Given the lack of difference in perceived stress, these results suggest that the use of cannabis as a coping aid may exacerbate poor sleep. Previous research indicates that Black women are not only more likely to report poor sleep, but that they also report exploring non-traditional strategies to address their sleep problems. These findings suggest a need to examine these non-traditional coping strategies for possible paradoxical and deleterious effects. Support (If Any) Funding: R01HL142066, R01HL095799, RO1MD004113, R01HL152453, 1R15 DA052886-01A1
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