The Relationship of Sleep Duration with Ethnicity and Chronic Disease in a Canadian General Population Cohort

Abstract

Mandeep Singh,1– 3 Kelly A Hall,4 Amy Reynolds,5 Lyle J Palmer,4,* Sutapa Mukherjee6,7,* 1Department of Anesthesiology and Pain Management, Women’s College Hospital, Toronto, Canada; 2Department of Anaesthesiology and Pain Management, Toronto Western Hospital, University Health Network, Toronto, Canada; 3Toronto Sleep and Pulmonary Centre, Toronto, Canada; 4School of Public Health, University of Adelaide, Adelaide, SA, Australia; 5Appleton Institute, CQ University Australia, Wayville, SA, Australia; 6Respiratory and Sleep Services, Southern Adelaide Local Health Network, Adelaide, SA, Australia; 7Adelaide Institute for Sleep Health, Flinders University, Adelaide, SA, Australia*These authors contributed equally to this workCorrespondence: Sutapa MukherjeeAdelaide Institute for Sleep Health, Flinders University, Adelaide, SA, AustraliaTel [phone]Email [email protected] Objectives: Sleep duration is an important marker of sleep quality and overall sleep health. Both too little and too much sleep are associated with poorer health outcomes. We hypothesized that ethnicity-specific differences in sleep duration exist.Methods: This cross-sectional study utilized questionnaire data from the Ontario Health Study (OHS), a multi-ethnic population-based cohort of Canadian adult residents aged 18 to 99 years, who provided medical, socio-demographic, and sleep information. Generalised linear models were used to investigate the association of sleep duration with ethnicity.Results: The study sample consisted of 143,307 adults (60.4% women). The sample was multi-ethnic, including self-identified Aboriginal, Arab, Black, Chinese, Filipino, Hispanic, Japanese, Korean, Mixed (> 1 ethnicity), South Asian, South-East Asian, West Asian, and White ethnicities. Univariate analyses found that mean sleep duration compared to the White reference group (7.34 hours) was shorter in the Filipino (6.93 hours, 25 min less), Black (6.96 hours, 23 min less), Japanese (7.02 hours, 19 min less), Chinese (7.23 hours, 7 min less), and Mixed (7.27 hours, 4 min less) groups (all P< 0.001). Mean sleep duration was shorter in men (7.25 hours) compared to women (7.37 hours) in the cohort as a whole (P< 0.001), and in all ethnic groups (P< 0.001). Multivariate analyses, adjusted for a wide range of potential risk factors, and analysis of sleep duration as a categorical variable (“short”, “average”, and “long” sleepers) confirmed these relationships. Both sleep duration and ethnicity were independent significant predictors of a range of physician-diagnosed morbidities including diabetes, stroke, and depression.Conclusion: Important differences exist in sleep duration between ethnic groups and may contribute to observed health disparities. Our results highlight the need for ethnicity-specific targeted education on the importance of prioritizing sleep for good health, and the need to account appropriately for ethnicity in future epidemiological, clinical, and translational research into sleep and related conditions.Keywords: sleep health, sleep duration, ethnicity, population health, health disparity

Keywords

• sleep health sleep duration ethnicity population health health disparity