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Influence of Race and Socioeconomic Status on Sleep: Pittsburgh SleepSCORE Project

From the Departments of Psychology (E.J.M., T.W.K.), Psychiatry (K.A.M., M.H., D.J.B., J.F.O.), and Medicine (P.J.S.), University of Pittsburgh, Pittsburgh, Pennsylvania; and Cardiovascular Institute (S.E.R.), University of Pittsburgh, Pittsburgh, Pennsylvania.

Address correspondence and reprint requests to Karen A. Matthews, Department of Psychiatry, University of Pittsburgh School of Medicine, 3811 O’Hara Street, Pittsburgh, PA 15213. E-mail: matthewska{at}upmc.edu

Objective: To examine the independent and interactive effects of race and socioeconomic status (SES) on objective indices and self-reports of sleep.

Methods: The sleep of 187 adults (41% black; mean age = 59.5 ± 7.2 years) was examined. Nine nights of actigraphy and two nights of inhome polysomnography (PSG) were used to assess average sleep duration, continuity, and architecture; self-report was used to assess sleep quality. Psychosocial factors, health behaviors, and environmental factors were also measured.

Results: Blacks had shorter sleep duration and lower sleep efficiency, as measured by actigraphy and PSG, and they spent less time proportionately in Stage 3–4 sleep, compared with others (p < .01). Lower SES was associated with longer actigraphy-measured latency, more wake after sleep onset as measured by PSG, and poorer sleep quality on the Pittsburgh Sleep Quality Index (p < .05).

Conclusions: Blacks and perhaps individuals in lower SES groups may be at risk for sleep disturbances and associated health consequences.

Key Words: race • socioeconomic status • sleep • polysomnography • actigraphy

Abbreviations: SES = socioeconomic status; PSG = polysomnography; WASO = wake after sleep onset; HeartSCORE = Heart Strategies Concentrating On Risk Evaluation; PSQI = Pittsburgh Sleep Quality Index; ESS = Epworth Sleepiness Scale; EOG = electro-oculogram; EMG = electromyogram; ECG = electrocardiogram; REM = rapid eye movement; AHI = apnea/hypopnea index; BMI = body mass index; CES-D = Center for Epidemiological Studies Depression Scale; STAI = Spielberger Trait Anxiety Inventory; Ho = Cook-Medley Hostility Scale; SEI = Sleep Environment Inventory.