Elevated sleep disturbance among blacks in an urban family medicine practice

Purpose: Blacks experience a number of health disparities. Sleep disturbances contribute to poor health. This preliminary study explores whether a disparity in sleep disturbances exists among blacks compared with whites and others. Methods: A cross-sectional study was conducted in a sample (n = 92) of urban primary care patients (52% black, 46% white, and 2% other) from a university-based family medicine practice. Mean (SD) age was 51.9 years (8.9 years). Participants completed the Pittsburgh Sleep Quality Index, the Center for Epidemiologic Studies Depression Scale, Revised, and a checklist of chronic health conditions. Results: The rate of clinically meaningful sleep disturbance was 71%. In bivariate logistic regressions, black race was associated with sleep disturbance (odds ratio [OR], 3.00; 95% CI, 1.17-7.69). Controlling for income attenuated that association by about 11% (race OR, 2.71; 95% CI, 1.04 -7.06). Education explained about 35% (race OR, 2.39; 95% CI, 0.89-6.42). Adjustment for depression, chronic illness, and education simultaneously resulted in an estimate for race of OR, 2.44; 95% CI, 0.85-7.01. Conclusion: Being black is associated with a sleep disturbance that is accounted for only partially by depression, socioeconomic status, and disease burden. Black primary care patients may benefit from additional screening and monitoring of sleep difficulties. (J Am Board Fam Med 2011;24:161-168.).