Immigration as a Child May Be Associated with Worse Sleep Quality in Adulthood—The Africans in America Study

Introduction and Objective: Sleep quality affects cardiometabolic health and is adversely affected by stress. Stress may be magnified in the African immigrant community by the move from a majority to a minority population as well as the age of immigration and income. Due to the paucity data on sleep quality in African immigrants, we evaluated in 322 African-born Blacks enrolled in the Africans in America study (male 57%): (a) sleep quality; (b) the influence of stress, age of immigration, gender and income on sleep quality; (c) the association between adverse health, specifically type 2 diabetes (T2D) and sleep quality. Methods: The Pittsburgh Sleep Quality Index (PSQI) and Cohen’s Perceived Stress Scale (PSS) were used to assess sleep and stress in the month prior to enrollment. Low income was defined as <45k/year. All participants were ≥20y at enrollment. Childhood immigration was defined by arriving in the United States <18y. Regression analyses was performed with PSQI as the dependent variable and PSS, income, gender and age of immigration as independent variables. OGTT were performed to determine the relationship between poor sleep quality (PSQI>5) and T2D. Results: The mean age of participants was: 40±11y (mean±SD), range 20-70y. The frequency of Childhood (Child-I) and Adult immigrants (Adult-I) were: 18% (57/322) and 82% (265/322), resp. PSQI was higher in Child-I than Adult-I (6±4 vs 5±3,P=0.023). Neither PSS nor income differed by age of immigration (both P>0.9). In the regression analyses, PSQI was adversely affected by PSS (P=0<.001), age of immigration (P=0.013), and income (P=0.072). Gender had no effect (P=0.508). The prevalence of diabetes tended to be higher in the group with poor sleep quality (10% vs 6%, P=0.156). Conclusion: Poor sleep quality in African Immigrants is modified not only by stress and income but also by arriving in the United States as a child. Determining the lifetime impact of age of immigration on sleep quality and its association with the development of T2D are worthy of study. Disclosure: E.A. Huefner: None. M. Sayed: None. G.G. Smith: None. K. Ntabadde: None. K. Meda: None. C. DuBose: None. P.L. Whitesell: None. A.E. Sumner: None.