Sleep Outcomes Among Subgroups of Asian American Survey Participants

Among Asian Americans, those of Filipino descent reported the highest burden of poor sleep, according to findings published in the Journal of Clinical Sleep Medicine.

Data for this study were sourced from the National Health Interview Survey (NHIS), a national cross-sectional household interview survey conducted in the United States (US), between 2006 and 2018. Researchers compared 5 sleep outcomes between participants who self-identified as Asian American (n=61,122) and those who self-identified as non-Hispanic White (n=523,148): sleep duration, sleep quality, trouble falling asleep, trouble staying asleep, and sleep medication usage.

Participants who identified as Asian American were divided into 4 ethnic groups: those who self-identified as Filipino (13,211), those who identified as Chinese (12,056), Asian Indian (11,249), and other Asians (21,767). Participants in the Asian and White groups were 48.3% and 48.5% men, respectively.

Overall, 65.3% of all participants reported sufficient sleep. Stratified by group, the highest proportion of sufficient sleep was reported by participants in the Asian Indian subgroup (75.5%), followed by those in the Chinese group (73.6%), those in the White group (70.8%), those in the other Asian group (65.9%), and those in the Filipino group (61.6%).

Compared with participants in the White group who reported they wake up feeling rested (36.4%), more participants in the Asian groups reported they wake up feeling rested (range, 39.6%-50.9%; all P <.05). Similarly, more participants in the Asian groups reported no trouble staying asleep (range, 64.9%-81.8%; all P <.05) compared with those in the White group (56.7%). Of participants in the White group, 61.8% reported they had no trouble falling asleep, whereas 76.7% of those in the Asian Indian, 73.3% of those in the Chinese, and 71% in the other Asians groups reported they had no trouble falling asleep. Participants in the Filipino group reported similar rates (62.3%) as those in the White group.

Similarly, participants in the Asian group reported significantly less sleep medication usage (range, 3.82%-10.33%; all P <.05) than those in the White group (16.6%).

In general, participants in the Asian groups were less likely to report having trouble staying asleep (aOR, 0.76), or report taking sleep medications (aOR, 0.61) compared with those in the White group. Among the subgroups, those that deviated from the overall patterns included participants in the Filipino group, who were less likely to report sufficient sleep (aOR, 0.58) and more likely to have trouble falling asleep (aOR, 1.19) than those in the White group. Those in the Asian Indian and other Asians groups were more likely to wake up feeling rested than those in the White group.

Among participants in the Filipino group, the greatest predictors for insufficient sleep included severe psychological distress (odds ratio [OR], 0.3), age between 45 and 64 years (OR, 0.59), age between 26 and 44 years (OR, 0.64), being foreign-born and living in the US for over 10 years (OR, 0.68), and fair or poor health (OR, 0.7).

For those in the Asian Indian group, the greatest predictors for sufficient sleep included being a former smoker (OR, 1.7) and being foreign-born and living in the US for 10 or fewer years (OR, 1.68).

The limitations of this study included the cross-sectional design and the self-reported outcomes. In addition, though NHIS included data on demographic, health and socioeconomic outcomes that may impact sleep, other important factors, such as screen time, sleep environment conditions, medical sleep disorders, media consumption around bedtime, or presence of everyday stressors, were not included.

These data indicated there was variation in sleep outcomes among individuals living in the US of Asian descent. “We found the highest burden of insufficient sleep among Filipinos and better sleep quality outcomes among Asian Indians compared to [non-Hispanic Whites.] By disaggregating NHIS [Asian American] data, we identified significant differences in sleep outcomes among different [Asian American] populations. This demonstrates the utility of disaggregating Asian American health outcomes in analyzing survey data to effectively focus public health efforts,” concluded the study authors.