Racial/ethnic disparities in subjective sleep duration, sleep quality, and sleep disturbances during pregnancy: an ECHO study

Author:

Lucchini Maristella1ORCID,O’Brien Louise M2ORCID,Kahn Linda G3ORCID,Brennan Patricia A4,Glazer Baron Kelly5,Knapp Emily A6ORCID,Lugo-Candelas Claudia1,Shuffrey Lauren1,Dunietz Galit Levi2ORCID,Zhu Yeyi78ORCID,Wright Rosalind J9,Wright Robert O9,Duarte Cristiane1,Karagas Margaret R10,Ngai Pakkay11,O’Connor Thomas G12,Herbstman Julie B13,Dioni Sean14,Singh Anne Marie15,Alcantara Carmela16,Fifer William P1,Elliott Amy J17,Jacobson L P18,Parker C B19,Alshawabkeh A N20,Ownby D21,

Affiliation:

1. Department of Psychiatry, Columbia University Irving Medical Center , New York, NY , USA

2. Division of Sleep Medicine, Department of Neurology, and Department of Obstetrics & Gynecology, University of Michigan , Ann Arbor, MI , USA

3. Departments of Pediatrics and Population Health, New York University Grossman School of Medicine , New York, NY , USA

4. Psychology Department, Emory University , Atlanta, GA , USA

5. Department of Family and Preventive Medicine, University of Utah , Salt Lake City, UT , USA

6. Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health , Baltimore, MD , USA

7. Division of Research, Kaiser Permanente Northern California , Oakland, CA , USA

8. Department of Epidemiology & Biostatistics, University of California , San Francisco, San Francisco, CA , USA

9. Department of Environmental Medicine and Public Health and Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai , New York, NY , USA

10. Department of Epidemiology, Geisel School of Medicine at Dartmouth College , Hanover, NH , USA

11. Division of Pediatric Pulmonology, Department of Pediatrics, Hackensack Meridian School of Medicine , Hackensack, NJ , USA

12. Departments of Psychiatry, Psychology, Neuroscience, and Obstetrics and Gynecology, University of Rochester , Rochester, NY , USA

13. Department of Environmental Health Sciences, Mailman School of Public Health , New York NY , USA

14. Department of Pediatrics, Warren Alpert Medical School at Brown University , Providence, RI , USA

15. Department of Pediatrics, University of Wisconsin School of Medicine and Public Health , Madison, WI , USA

16. School of Social Work, Columbia University , New York, NY , USA

17. Avera Research Institute , Sioux Falls, SD , USA

18. Johns Hopkins University Bloomberg School of Public Health , Baltimore, Maryland

19. Research Triangle Institute , Durham, North Carolina

20. Northeastern University , Boston, Massachusetts

21. Henry Ford Health System , Detroit, Michigan

Abstract

Abstract In the United States, racial/ethnic minoritized groups experience worse sleep than non-Hispanic Whites (nHW), but less is known about pregnant people. This is a key consideration since poor sleep during pregnancy is common and associated with increased risk of adverse perinatal outcomes. This study reports the prevalence of subjective sleep measures in a multi-racial/ethnic pregnant population from the Environmental influences on Child Health Outcomes (ECHO) program. Participants’ self-reported race and ethnicity were grouped into: nHW, non-Hispanic Black/African American (nHB/AA), Hispanic, non-Hispanic Asian (nHA). Analyses examined trimester-specific (first (T1), second (T2), third (T3)) nocturnal sleep duration, quality, and disturbances (Pittsburgh Sleep Quality Index and ECHO maternal sleep health questionnaire). Linear or multinomial regressions estimated the associations between race/ethnicity and each sleep domain by trimester, controlling for body mass index and age, with nHW as reference group. We repeated analyses within maternal education strata. nHB/AA participants reported shorter sleep duration (T2: β = –0.55 [–0.80,–0.31]; T3: β = –0.65 [–0.99,–0.31]) and more sleep disturbances (T2: β = 1.92 [1.09,2.75]; T3: β = 1.41 [0.09,2.74]). Hispanic participants reported longer sleep duration (T1: β = 0.22 [0.00004,0.44]; T2: β = 0.61 [0.47,0.76]; T3: β = 0.46 [0.22,0.70]), better sleep quality (Reference group: Very good. Fairly good T1: OR = 0.48 [0.32,0.73], T2: OR = 0.36 [0.26,0.48], T3: OR = 0.31 [0.18,0.52]. Fairly bad T1: OR = 0.27 [0.16,0.44], T2: OR = 0.46 [0.31, 0.67], T3: OR = 0.31 [0.17,0.55]), and fewer sleep disturbances (T2: β = –0.5 [–1.0,–0.12]; T3: β = –1.21 [–2.07,–0.35]). Differences persisted within the high-SES subsample. Given the stark racial/ethnic disparities in perinatal outcomes and their associations with sleep health, further research is warranted to investigate the determinants of these disparities.

Funder

National Institutes of Health

Publisher

Oxford University Press (OUP)

Subject

Physiology (medical),Neurology (clinical)

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