The Contribution of Psychosocial Stressors to Sleep among African Americans in the Jackson Heart Study

Abstract

Studies have shown that psychosocial stressors are related to poor sleep. However, studies of African Americans, who may be more vulnerable to the impact of psychosocial stressors, are lacking. Using the Jackson Heart Study (JHS) baseline data, we examined associations of psychosocial stressors with sleep in 4,863 African Americans. We examined cross-sectional associations between psychosocial stressors and sleep duration and quality in a large population sample of African Americans. Three measures of psychosocial stress were investigated: the Global Perceived Stress Scale (GPSS); Major Life Events (MLE); and the Weekly Stress Inventory (WSI). Sleep was assessed using self-reported hours of sleep and sleep quality rating (1 = poor; 5 = excellent). Multinomial logistic and linear regression models were used to examine the association of each stress measure (in quartiles) with continuous and categorical sleep duration (< 5 (“very short”), 5–6 h (“short”) and ≥ 9 h (“long”) versus 7 or 8 h (“normal”); and with sleep quality after adjustment for demographics and risk factors (body mass index, hypertension, diabetes, physical activity). Mean age of the sample was 54.6 years and 64% were female. Mean sleep duration was 6.4 + 1.5 hours, 54% had a short sleep duration, 5% had a long sleep duration, and 34% reported a “poor” or “fair” sleep quality. Persons in the highest GPSS quartile had higher odds of very short sleep (odds ratio: 2.87, 95% confidence interval [CI]: 2.02, 4.08), higher odds of short sleep (1.72, 95% CI: 1.40, 2.12), shorter average sleep duration (? = −33.6 min (95% CI: −41.8, −25.4), and reported poorer sleep quality (? = −0.73 (95% CI: −0.83, −0.63) compared to those in the lowest quartile of GPSS after adjustment for covariates. Similar patterns were observed for WSI and MLE. Psychosocial stressors were not associated with long sleep. For WSI, effects of stress on sleep duration were stronger for younger (< 60 y) and college-educated African-Americans. Psychosocial stressors are associated with higher odds of short sleep, lower average sleep duration, and lower sleep quality in African Americans. Psychosocial stressors may be a point of intervention among African Americans for the improvement of sleep and downstream health outcomes. African Americans report shorter sleep duration and a poorer sleep quality than non-Hispanic whites, however, few studies have investigated the determinants of poor sleep among African Americans. We investigated associations between chronic and acute stressors and sleep duration and quality in a large population of African Americans given African Americans have both a high prevalence of stress and may have a differential vulnerability to the impact of stressors on sleep relative to non-Hispanic whites. We observed clinically meaningful differences in sleep duration and quality comparing individuals with higher and lower reports of psychosocial stress. Future research should identify potential buffers that may mitigate the effects of psychosocial stressors in this population to improve sleep and subsequent health outcomes.

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