Sleep deficiency among Native Hawaiian/Pacific Islander, Black, and White Americans and the association with cardiometabolic diseases: analysis of the National Health Interview Survey Data

Purpose: Examine sleep deficiency, factors, and associations with cardiometabolic diseases in United States Native Hawaiian/Pacific Islanders (NHPI), Blacks, and Whites. Design: Data from the 2014 National Health Interview Survey and NHPI National Health Interview Survey household interviews of adults were analyzed. Participants: Of 31,724 participants, 7% were NHPI, 14% were Black, and 79% were White. Methods: Habitual sleep duration and quality, sociodemographic/economic covariates, health behaviors, psychological distress, and chronic diseases were self-reported. Sleep duration was coded as very short (VSS; <5 hours), short (SS; 5-6 hours), long (LS; >8 hours), or healthy (7-8 hours). Using multivariate logistic regressions, the association between sleep duration and diseases was assessed after adjusting for covariates. Results: NHPI were more likely to report sleep <7 hours compared to Whites (40.2% NHPI, 29.3% White) and less LS than Blacks (7% NHPI, 9.2% Black), report poor sleep quality, and use fewer sleep medications. VSS was related to smoking and psychological distress in NHPI men. VSS was associated with hypertension and SS with diabetes in NHPI, even in adjusted models. The relationship between SS and diabetes was higher in NHPI (risk ratio [RR]: 1.40, 95% confidence interval [CI]: 1.03-1.90) than Whites (RR: 1.01, 95% CI: 0.90-1.14, P = .027) and Blacks (RR: 1.02, 95% CI: 0.85-1.23, P = .043) even after adjusting for other covariates. Conclusions: NHPI reported suboptimal sleep duration that was linked to hypertension and diabetes even after controlling for covariates. Additional prospective studies in NHPI are needed to understand biological, behavioral, and psychological factors of sleep deficiency and its impact on chronic diseases. (c) 2018 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.