Sleep health and serious psychological distress: A nationally representative study of the United States among white, black, and hispanic/latinx adults

Abstract

Purpose: Prior studies investigating the relationship between sleep and serious psychological distress (SPD) have lacked racial/ethnic diversity and generalizability. We investigated associations between sleep and SPD among a large, nationally representative, and racially/ ethnically diverse sample of US adults. Methods: We pooled cross-sectional data from the 2004 to 2017 National Health Interview Survey. Participants self-reported sleep duration and sleep disturbances (eg, trouble falling and staying asleep). SPD was defined as a Kessler Psychological Distress Scale (K6) score ≥13. Adjusting for sociodemographic, health behavior, and clinical characteristics, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) and 95% con-fidence intervals (CIs) of SPD for each sleep characteristic, overall and by race/ethnicity. Results: Among 316,840 participants, the mean age ± standard error was 46.9 ± 0.1 years, 52% were women, 75% were non-Hispanic (NH)-White, 16% NH-Black, and 9% Hispanic/ Latinx. The prevalence of SPD was 3.4% for NH-Whites, 4.1% for NH-Blacks, and 4.5% for Hispanics/Latinxs. Participants with <7 hours versus 7–9 hours of sleep duration were more likely to have SPD, and the magnitude of the association was strongest among NH-Black participants (PRNH-Blacks=3.50 [95% CI: 2.97–4.13], PRHispanics/Latinx=2.95 [2.42–3.61], and PRNH-Whites=2.66 [2.44–2.89]). Positive associations between sleep disturbances and SPD were generally stronger among NH-Black and Hispanic/Latinx compared to NH-White adults. Conclusion: Poor sleep health was positively associated with SPD, and the magnitude of the association was generally stronger among racial/ethnic minorities. Future investigations should prospectively focus on the determinants and health consequences of SPD attributable to objectively measured sleep across racial/ethnic groups.