Short sleep duration, insomnia disorder, and sleep apnea are all highly prevalent in the US population and are associated with significant morbidity, including poor mental health, impaired neurocognitive function, metabolic dysregulation, and cardiovascular disease. In the context of the high prevalence of pernicious sleep disturbances, there is evidence that sleep disparities exist in the population, such that racial/ethnic minorities ? including Mexican-Americans ? are at increased risk of sleep disturbances. This is alarming, since this group is also at increased risk for many of the adverse cardiometabolic and functional outcomes linked to sleep disturbances. These associations may be influenced by economic hardship, psychosocial stress, unhealthy behaviors (diet, exercise, alcohol, and smoking), and acculturation ? the degree to which an individual adopts (in this case) traditional Mexican versus American culture. The first goal of this project is to examine sleep duration, insomnia symptoms, and sleep apnea severity among Mexican-Americans and examine the role of these social-behavioral factors in this relationship. Second, this study aims to examine the role of sleep and cardiometabolic disease risk in this population and explore the role of acculturation, psychosocial stress, economic hardship, and/or unhealthy behaviors in these associations. To accomplish this, this project will partner with the Mariposa Community Health Center, the federally qualified clinic in the Nogales, AZ area. Nogales is a small city on the US/Mexico border that is an ideal location for studying non-urban Mexican- Americans, as it is made up of 83% Hispanics/Latinos, 33% immigrants, and 77% who primarily speak Spanish at home. This community-engaged project will partner with Mariposa and their Platicamos Salud program that uses experienced Community Health Workers (promotoras de salud) to collect data and perform home visits. The study will recruit N=900 Mexican-Americans and N=200 Non-Hispanic Whites to complete a battery of assessments from a clinic visit (questionnaires, interviews, exam for anthropometry and arterial stiffness, and collection of biomarkers), a 1-night home sleep apnea assessment, a 24-hour ambulatory blood pressure recording, and a 2-week home monitoring period with sleep diary and actigraphy. This will result in a rich dataset that can help to identify and reduce sleep disparities in the population and point to potential intervention approaches to reducing cardiometabolic disease disparities. The analytic plan will take advantage of a machine-learning analytic approach, which will be used to evaluate the complex relationships among all of these variables. This project will address many relevant issues in sleep medicine, health disparities research, and border health. The partnership with Mariposa will enhance recruitment, promote research integrity (or ensure appropriateness of research methods), and facilitate dissemination of the study results into the community through education programs associated with Platicamos Salud and other community outreach efforts.

Public Health Relevance

The primary goal of this study is to assess sleep health among Mexican-Americans at the US/Mexico border, characterize relationships with cardiometabolic disease risk, and investigate the role of social-environmental factors including acculturation, stress, socioeconomics, and health behaviors. Short sleep duration, insomnia disorder, and sleep apnea are highly prevalent in the population. These conditions are associated with cardiovascular disease, diabetes, daytime functioning problems, and poor mental health. Disparities in sleep health in racial/ethnic minorities exist, including Mexican-Americans. In particular, social-environmental factors at the US-Mexico border may play an important role in sleep health disparities. This project will not only allow for increased understanding of the complex relationship among sleep, health, and social-environmental pressures, but through a community partnership it can maximize our ability to reduce these disparities. Also, this project has the added benefit of providing information about the role of sleep as a potentially modifiable factor in cardiovascular disease and diabetes disparities as well.

Agency
National Institute of Health (NIH)
Institute
National Institute on Minority Health and Health Disparities (NIMHD)
Type
Research Project (R01)
Project #
5R01MD011600-03
Application #
9827495
Study Section
Health Disparities and Equity Promotion Study Section (HDEP)
Program Officer
Das, Rina
Project Start
2018-04-01
Project End
2022-11-30
Budget Start
2019-12-01
Budget End
2020-11-30
Support Year
3
Fiscal Year
2020
Total Cost
Indirect Cost
Name
University of Arizona
Department
Psychiatry
Type
Schools of Medicine
DUNS #
806345617
City
Tucson
State
AZ
Country
United States
Zip Code
85721
Rosenberger, Mary E; Fulton, Janet E; Buman, Matthew P et al. (2018) The 24-Hour Activity Cycle: A New Paradigm for Physical Activity. Med Sci Sports Exerc :
Mai, Quan D; Hill, Terrence D; Vila-Henninger, Luis et al. (2018) Employment insecurity and sleep disturbance: Evidence from 31 European countries. J Sleep Res :e12763
Grandner, Michael A; Watson, Nathaniel F; Kay, Matthew et al. (2018) Addressing the need for validation of a touchscreen psychomotor vigilance task: important considerations for sleep health research. Sleep Health 4:387-389
Grandner, Michael A (2018) The Cost of Sleep Lost: Implications for Health, Performance, and the Bottom Line. Am J Health Promot 32:1629-1634
Garland, Sheila N; Rowe, Hillary; Repa, Lily M et al. (2018) A decade's difference: 10-year change in insomnia symptom prevalence in Canada depends on sociodemographics and health status. Sleep Health 4:160-165
Grandner, Michael A (2017) Sleep, Health, and Society. Sleep Med Clin 12:1-22