21. October 2015 SLEEP & SOCIETY Seminar Sleep, Cognition & Health Hannah Hofmann & Amelie Reichenbecker
AGENDA 1. History of Sleep 2. Sleep & Cultural Differences Study 1: Sleep in America: Role of racial/ethnic differences Study 2: Sleep Symptoms, Race/Ethnicity, and Socioeconomic Position Study 3: Race and Financial Strain are Independent Correlates of Sleep in Midlife Women: The SWAN Sleep Study 3. Questions & Discussion
HISTORY OF SLEEP Earlier centuries: No research like today Literary sources Dreams have always been recorded
PRE-INDUSTRIAL SLEEP First and Second sleep Two phased sleep - 10pm-1am BREAK 2am-6am - Break: Meditation, make love, prayers References: Homer s Odyssey (7 th or 8 th century) medieval sources Classical work (18 th -19 th century)
CHANGES IN SLEEP BEHAVIOUR With industrialilisation bifurcated sleep changed: Why? More artificial light working situation changed: shift work Consume of tee and coffee Cultural life in cities Later to bed: Expansion of the first sleep at the expense of the second sleep
FIRST SLEEP- SECOND SLEEP DISAPPEARANCE Terms faded from English Dictionary Beginning of the 20th century Reasons: Little sleep Deeper sleep No awaking in the middle of the night Time conciousness: sleep as less as possible Better activity in the morning than sleeping
WHAT IS THAT?
CRITIQUE ON EARLY RISING Early Risers sacrifice their health for more profit Dehumanizing Artificial cut off
RELEVANCE FOR TODAY 1. Middle of the night insomnia is maybe not so unnatural as many people think 2. Artifical light changed and changes our sleep behaviour
IN SHORT PHOTOPERIODS, HUMAN SLEEP IS BIPHASIC (WEHR, T., 1991)
SLEEP IN AMERICA: ROLE OF RACIAL/ETHNIC DIFFERENCES (ADENEKAN ET AL., 2013) Study Objectives Examine epidemiologic and community-based data on sleep complaints reported by American adults Specifically addressing the role of race/ethnicity in the subjective report of sleep problems General Findings Decline of sleep duration in America from 1960 to 2000 Plateau at approximately 6-6.5 h for the last six years Well-established association between low socioeconomic status and sleep problems
SLEEP IN AMERICA: ROLE OF RACIAL/ETHNIC DIFFERENCES (ADENEKAN ET AL., 2013) Sleep duration: Evidence supporting racial/ethnic differences Blacks: Highest prevalence of long (9 h) and short sleep (5 h) Greater variation in their habitual sleep time Extreme sleep durations are associated with early mortality and ill health Sleep quality Poor sleep may mediate increased risk of type-2 diabetes, CVD, and obesity among blacks
SLEEP IN AMERICA: ROLE OF RACIAL/ETHNIC DIFFERENCES (ADENEKAN ET AL., 2013) Sleep complaints: Evidence supporting racial/ethnic differences Conflicting data, some studies suggesting blacks are least likely to report having a good night s sleep at least a few nights per week tended to report fewer sleep complaints & greater satisfaction with sleep Discrepancy in self-reports of sleep complaints among blacks in America
SLEEP SYMPTOMS, RACE/ETHNICITY, AND SOCIOECONOMIC POSITION (GRANDNER ET AL., 2013) Study Objectives Assess whether sleep symptoms are differentially endorsed relative to sociodemographic factors and/or socio-economic factors and Whether these relationships were maintained after adjustment for - Other sociodemographic/ socioeconomic factors - Overall health Data 2007-2008 National Health and Nutrition Examination Survey Healthy, non-clinical sample (N = 4,081)
SLEEP SYMPTOMS, RACE/ETHNICITY, AND SOCIOECONOMIC POSITION (GRANDNER ET AL., 2013) Self-reported sleep symptoms included Sleep latency > 30 min Non-restorative sleep Daytime sleepiness Snorting/gasping and Snoring Sociodemographic variables included Race/ethnicity (Non-Hispanic white, Black/African American, Mexican-American, Other Hispanic/Latino, and Asian/other) Immigration status (born in the US, born in Mexico, or born in another country) Age, sex, and marital status
SLEEP SYMPTOMS, RACE/ETHNICITY, AND SOCIOECONOMIC POSITION (GRANDNER ET AL., 2013) Overall results: Race/ Ethnicity Number of patterns of sleep symptoms relative to race/ethnicity, Majority explained by other sociodemographic, socio-economic, and health variables. 1. Hispanic/ Latino & Mexican Americans Sleep symptoms evaluated separately for Mexican Americans and other Hispanic/Latino Both less likely to report difficulty falling asleep, daytime sleepiness, and non-restorative sleep. Other Hispanic/Latino: More snorting/gasping and snoring
SLEEP SYMPTOMS, RACE/ETHNICITY, AND SOCIOECONOMIC POSITION (GRANDNER ET AL., 2013) Overall results: Race/ Ethnicity 2. Black/African American: Increased risk for insomnia and greater risk for both short and long sleep duration but more likely to deny experiencing symptoms. 3. Asian/ Others Little to no difference between sleep symptoms among Asians/Others and non-hispanic Whites Only exception: Lower rate of non-restorative sleep among Asians/Others This exception is consonant with previous findings, which have shown lower rates of sleep disturbances among Asians.
SLEEP SYMPTOMS, RACE/ETHNICITY, AND SOCIOECONOMIC POSITION (GRANDNER ET AL., 2013) Results: Immigration status Those born in Mexico are less likely than US-born respondents to report many sleep symptoms. Being born in a different country seems to be protective Consistent with previous findings that immigrants report fewer sleep symptoms.
RACE AND FINANCIAL STRAIN ARE INDEPENDENT CORRELATES OF SLEEP IN MIDLIFE WOMEN: THE SWAN SLEEP STUDY (HALL ET AL., 2009) Study Objectives: Examine racial differences in sleep in a large cohort of midlife women Evaluate whether indices of socioeconomic status (SES) are associated with racial differences in sleep Participants: Caucasian (n = 171), African American (n = 138) Chinese women (n = 59) Measurements: Sleep quality: Pittsburgh Sleep Quality Index Indices of SES: Self-reported educational attainment & financial strain
THE PITTSBURGH SLEEP QUALITY INDEX (PSQI)
RACE AND FINANCIAL STRAIN ARE INDEPENDENT CORRELATES OF SLEEP IN MIDLIFE WOMEN: THE SWAN SLEEP STUDY (HALL ET AL., 2009) Results concerning cultural differences Sleep was worse in African American women than Caucasian Slow wave sleep differences between Chinese and Caucasian participants Racial differences persisted after adjustment for indices of SES
QUESTIONS & DISCUSSION Do you have any questions? Why does being born in a different country (in comparison to born in the US) seem to be protective when it comes to sleeping problems? How could you use these findings about cultural differences to improve sleep quality? What is the future of sleep? How do we sleep in 50 or 100 years?
Early to bed, early to rise, makes a man healthy, wealthy and wise. Early to rise, early to bed, makes a man healthy wealthy and dead. Benjamin Franklin James Thurber
THANK YOU VERY MUCH FOR YOUR ATTENTION!
REFERENCES Adenekan, B., Pandey, A., McKenzie, S., Zizi, F., Casimir, G. J., & Jean-Louis, G. (2013). Sleep in America: Role of racial/ethnic differences. Sleep medicine reviews, 17(4), 255-262. Ekirch, A. R. (2015). The Modernization of Western Sleep: Or, Does Insomnia have a History? Past & Present, 226(1), 149-192. Grandner, M. A., Petrov, M. E. R., Rattanaumpawan, P., Jackson, N., Platt, A., & Patel, N. P. (2013). Sleep symptoms, race/ethnicity, and socioeconomic position. Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine, 9(9), 897. Hall, M. H., Matthews, K. A., Kravitz, H. M., Gold, E. B., Buysse, D. J., Bromberger, J. T.,... & Sowers, M. (2009). Race and financial strain are independent correlates of sleep in midlife women: the SWAN sleep study. Sleep, 32(1), 73. Wehr, T. A. (1992). In short photoperiods, human sleep is biphasic. Journal of Sleep Research, 1(2), 103 107