Acculturation and Sleep Among a Multiethnic Sample of Women
The Study of Women's Health Across the Nation (SWAN)
Published In: Sleep, v. 37, no. 2, Feb. 2014, p. 309-317
Posted on RAND.org on February 01, 2014
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STUDY OBJECTIVES: 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. DESIGN: Cross-sectional observational study. SETTING: Multisite study in Oakland, CA; Los Angeles, CA; and Newark, NJ. PARTICIPANTS: 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. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: 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. CONCLUSION: 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.