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Singh R, Gilles AA, McGrath J, Zhou ZE, Jackson CL. Disparities in sleep duration and quality by industry of employment and occupational class among Native Hawaiian/Pacific Islanders and non-Hispanic Whites in the United States. Sleep Health 2024; 10:425-433. [PMID: 38890042 DOI: 10.1016/j.sleh.2024.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 03/04/2024] [Accepted: 05/14/2024] [Indexed: 06/20/2024]
Abstract
OBJECTIVE To investigate disparities in the work-sleep relationship between Native Hawaiian/Pacific Islanders (NHPIs) and non-Hispanic (NH)-White populations. METHODS Using data from a nationally representative sample of U.S. adults (n = 20,828) in the 2014 National Health Interview Survey, we estimated prevalence of short sleep duration (<7 hours) among NHPIs (10%) and NH-Whites for each of 7 employment industry categories and 3 occupational classes. Mean age was 41 ± 0.5years for NHPIs and 49 ± 0.2years for NH-Whites. Women comprised 52% of both groups. RESULTS NHPIs were more likely than NH-Whites to report short sleep duration across all industry of employment categories (except for food and accommodation services) and occupational classes. The disparity was widest among NHPI and NH-White workers in the "professional/management" industry category, with NHPIs having higher prevalence of very short (<6 hours; 20% vs. 7%) and short sleep (30% vs. 22%) durations and lower prevalence of recommended sleep duration (45% vs. 68%) and waking up feeling rested (53% vs. 67%). Among the occupational classes, the NHPI-White disparity was widest among participants who held support service occupations. Although professionals had the lowest and laborers had the highest prevalence of short sleep among the three occupational classes in both NHPI and NH-White groups, short sleep duration prevalence was higher among NHPI professionals (35%) than NH-White laborers (33%). NH-White workers across industry and occupational classes had higher sleep medication use prevalence compared to NHPI workers. CONCLUSIONS The work environment via occupation type may contribute to racial/ethnic disparities in short sleep. Further investigations are warranted.
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Affiliation(s)
- Rupsha Singh
- Intramural Research Program, National Institute on Aging, National Institutes of Health, Department of Health and Human Services, Baltimore, Maryland, USA
| | - Allyson A Gilles
- Social Sciences Division, University of Hawai'i West O'ahu, Kapolei, Hawaii, USA
| | - John McGrath
- Social & Scientific Systems, Inc., Research Triangle Park, North Carolina, USA
| | - Zhiqing E Zhou
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA; Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA.
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Fonseca LM, Finlay MG, Chaytor NS, Morimoto NG, Buchwald D, Van Dongen HPA, Quan SF, Suchy-Dicey A. Mid-life sleep is associated with cognitive performance later in life in aging American Indians: data from the Strong Heart Study. Front Aging Neurosci 2024; 16:1346807. [PMID: 38903901 PMCID: PMC11188442 DOI: 10.3389/fnagi.2024.1346807] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/23/2024] [Indexed: 06/22/2024] Open
Abstract
Background Sleep-related disorders have been associated with cognitive decline and neurodegeneration. American Indians are at increased risk for dementia. Here, we aim to characterize, for the first time, the associations between sleep characteristics and subsequent cognitive performance in a sample of aging American Indians. Methods We performed analyses on data collected in two ancillary studies from the Strong Heart Study, which occurred approximately 10 years apart with an overlapping sample of 160 American Indians (mean age at follow-up 73.1, standard deviation 5.6; 69.3% female and 80% with high school completion). Sleep measures were derived by polysomnography and self-reported questionnaires, including sleep timing and duration, sleep latency, sleep stages, indices of sleep-disordered breathing, and self-report assessments of poor sleep and daytime sleepiness. Cognitive assessment included measures of general cognition, processing speed, episodic verbal learning, short and long-delay recall, recognition, and phonemic fluency. We performed correlation analyses between sleep and cognitive measures. For correlated variables, we conducted separate linear regressions. We analyzed the degree to which cognitive impairment, defined as more than 1.5 standard deviations below the average Modified Mini Mental State Test score, is predicted by sleep characteristics. All regression analyses were adjusted for age, sex, years of education, body mass index, study site, depressive symptoms score, difference in age from baseline to follow-up, alcohol use, and presence of APOE e4 allele. Results We found that objective sleep characteristics measured by polysomnography, but not subjective sleep characteristics, were associated with cognitive performance approximately 10 years later. Longer sleep latency was associated with worse phonemic fluency (β = -0.069, p = 0.019) and increased likelihood of being classified in the cognitive impairment group later in life (odds ratio 1.037, p = 0.004). Longer duration with oxygen saturation < 90% was associated with better immediate verbal memory, and higher oxygen saturation with worse total learning, short and long-delay recall, and processing speed. Conclusion In a sample of American Indians, sleep characteristics in midlife were correlated with cognitive performance a decade later. Sleep disorders may be modifiable risk factors for cognitive impairment and dementia later in life, and suitable candidates for interventions aimed at preventing neurodegenerative disease development and progression.
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Affiliation(s)
- Luciana Mascarenhas Fonseca
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States
- Programa Terceira Idade (PROTER, Old Age Research Group), Department and Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Pullman, WA, United States
| | - Myles G. Finlay
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States
- Sleep and Performance Research Center, Washington State University, Spokane, WA, United States
| | - Naomi S. Chaytor
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States
| | - Natalie G. Morimoto
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States
| | - Dedra Buchwald
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Pullman, WA, United States
| | - Hans P. A. Van Dongen
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA, United States
- Sleep and Performance Research Center, Washington State University, Spokane, WA, United States
| | - Stuart F. Quan
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, University of Arizona College of Medicine, Tucson, AZ, United States
| | - Astrid Suchy-Dicey
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Pullman, WA, United States
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Willis DE, Kaholokula JK, Andersen JA, Selig JP, Bogulski CA, Scott AJ, McElfish PA. Racial Misclassification, Discrimination, Consciousness, and Self-Rated Health Among Native Hawaiian and Pacific Islander Adults in the USA. J Racial Ethn Health Disparities 2024; 11:730-738. [PMID: 36892814 PMCID: PMC9997430 DOI: 10.1007/s40615-023-01556-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/22/2023] [Accepted: 02/23/2023] [Indexed: 03/10/2023]
Abstract
BACKGROUND Medical researchers have historically utilized the variable of race uncritically, rarely defining race, rarely acknowledging it as a social construct, and often omitting information about how it was measured. In this study, we use the following definition of race: "a system of structuring opportunity and assigning value based on the social interpretation of how one looks." We examine the influence of racial misclassification, racial discrimination, and racial consciousness on the self-rated health of Native Hawaiian and Pacific Islanders (NHPI) living in the United States of America (USA). METHODS Our analysis used online survey data from a subgroup of NHPI adults living in the USA (n = 252) who were oversampled as part of a larger study of US adults (N = 2022). Respondents were recruited between September 7, 2021 and October 3, 2021, from an online opt-in panel of individuals across the USA. Statistical analyses include weighted and unweighted descriptive statistics for the sample, as well as a weighted logistic regression for poor/fair self-rated health. RESULTS Odds of poor/fair self-rated health were greater for women (OR = 2.72; 95% CI [1.19, 6.21]) and those who experienced racial misclassification (OR = 2.90; 95% CI [1.20, 7.05]). No other sociodemographic, healthcare, or race-related variables were significantly associated with self-rated health in the fully adjusted results. CONCLUSIONS Findings suggest that racial misclassification may be an important correlate of self-rated health among NHPI adults in the US context.
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Affiliation(s)
- Don E Willis
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA.
| | - Joseph Keawe'aimoku Kaholokula
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawai'i at Manoa, Honolulu, HI, USA
| | - Jennifer A Andersen
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
| | - James P Selig
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - Cari A Bogulski
- College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Aaron J Scott
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Springdale, AR, USA
| | - Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 2708 S. 48th St., Springdale, AR, 72762, USA
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Heinsberg LW, Pomer A, Cade BE, Carlson JC, Naseri T, Reupena MS, Viali S, Weeks DE, McGarvey ST, Redline S, Hawley NL. Characterization of sleep apnea among a sample of adults from Samoa. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.11.16.23298644. [PMID: 38014025 PMCID: PMC10680886 DOI: 10.1101/2023.11.16.23298644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
Sleep apnea is a public health concern around the world, but little research has been dedicated to examining this issue in low- and middle-income countries, including Samoa. Using data collected through the Soifua Manuia ("Good Health") study, which aimed to investigate the impact of the body mass index (BMI)-associated genetic variant rs373863828 in CREB3 Regulatory Factor ( CREBRF ) on metabolic traits in Samoan adults, we examined the sample prevalence and characteristics of sleep apnea using data collected with a validated home sleep apnea device (WatchPAT, Itamar). A total of 330 participants (sampled to overrepresent the obesity-risk allele of interest) had sleep data available. Participants (53.3% female) had a mean (SD) age of 52.0 (9.9) years and BMI of 35.5 (7.5) kg/m 2 and 36.3% of the sample had type 2 diabetes. Based on the 3% and 4% apnea hypopnea indices (AHI) and the 4% oxygen desaturation index (ODI), descriptive analyses revealed that many participants had potentially actionable sleep apnea defined as >5 events/hr (87.9%, 68.5%, and 71.2%, respectively) or clinically actionable sleep apnea defined as ≥15 events/hr (54.9%, 31.5%, and 34.5%, respectively). Sleep apnea was more severe in men; for example, clinically actionable sleep apnea (≥15) based on the AHI 3% definition was observed in 61.7% of men and 48.9% of women. Correction for non-representational sampling related to the CREBRF obesity-risk allele resulted in only slightly lower estimates. Across the AHI 3%, AHI 4%, and ODI 4%, multiple linear regression revealed associations between a greater number of events/hr and higher age, male sex, higher body mass index, higher abdominal-hip circumference ratio, and geographic region of residence. Our study identified a much higher frequency of sleep apnea in Samoa compared with published data from other studies, but similar predictors. Continued research addressing generalizability of these findings, as well as a specific focus on diagnosis and affordable and equitable access to treatment, is needed to alleviate the burden of sleep apnea in Samoa and around the world.
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Rainer MA, Palmer PH, Xie B. Sleep Duration and Chronic Disease Among Older Native Hawaiians or Other Pacific Islanders and Asians: Analysis of the Behavioral Risk Factor Surveillance System. J Racial Ethn Health Disparities 2023; 10:2302-2311. [PMID: 36109435 DOI: 10.1007/s40615-022-01409-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 08/30/2022] [Accepted: 08/31/2022] [Indexed: 11/24/2022]
Abstract
OBJECTIVES Older adults are particularly vulnerable to unhealthy sleep. This study examines the relationship between sleep duration and chronic diseases among older Native Hawaiians or Other Pacific Islanders (NHOPIs) and identifies variations with older Asians. METHODS In this cross-sectional study, data were analyzed using the 2016 Behavioral Risk Factor Surveillance System. The total sample of adults 50 years and older included 1277 NHOPIs and 4655 Asians. Weighted, survey logistic regressions were employed to analyze the relationship between sleep duration (i.e., short, healthy, and long) and seven chronic diseases: coronary heart disease, stroke, heart attack/myocardial infarction, pre-diabetes, diabetes, chronic obstructive pulmonary disease, and depressive disorder. Sleep duration was categorized into short sleep (SS; ≤ 6 h), healthy sleep (7-8 h), and long sleep (LS; ≥ 9 h), with healthy sleep as the reference group. RESULTS Among NHOPIs, SS and LS were significantly related to stroke (OR 3.19, 95% CI: 1.35-7.53 for SS and OR 9.52, 95% CI: 2.99-30.34 for LS) and SS was associated with pre-diabetes (OR 2.22 CI: 1.07-4.59), after adjusting for all covariates. In contrast, Asians with SS and LS reported higher odds of depression (OR 2.40, 95% CI: 1.20-4.79 and OR 5.03, 95% CI: 1.57-16.13, respectively). CONCLUSIONS Findings suggest older NHOPIs with SS or LS experience worse health. NHOPIs and Asians varied on the relationship between sleep and chronic disease, underscoring the need to disaggregate Asian/NHOPI data to understand health disparities.
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Affiliation(s)
- Michelle A Rainer
- School of Community and Global Health, Claremont Graduate University, 150 E 10th St, Claremont, CA, 91711, USA.
| | - Paula Healani Palmer
- School of Community and Global Health, Claremont Graduate University, 150 E 10th St, Claremont, CA, 91711, USA
| | - Bin Xie
- School of Community and Global Health, Claremont Graduate University, 150 E 10th St, Claremont, CA, 91711, USA
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Simonsen SE, Sunada GR, Digre K, Stark LA, Mukundente V, Napia E, Tavake-Pasi F, Villalta J, Lee D, Davis F, Sanchez-Birkhead A, Brown BH, Baron KG. Short sleep duration and interest in sleep improvement in a multi-ethnic cohort of diverse women participating in a community-based wellness intervention: an unmet need for improvement. BMC Womens Health 2023; 23:188. [PMID: 37081433 PMCID: PMC10120218 DOI: 10.1186/s12905-023-02341-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 04/06/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Disparities in sleep duration are a modifiable contributor to increased risk for cardiometabolic disorders in communities of color. We examined the prevalence of short sleep duration and interest in improving sleep among a multi-ethnic sample of women participating in a culturally tailored wellness coaching program and discussed steps to engage communities in sleep health interventions. METHODS Secondary analysis of data from a randomized trial were used. The wellness coaching trial utilized a Community-Based Participatory Research (CBPR) approach. Data were from the baseline survey and baseline wellness coaching notes. Short sleep duration was defined as < 7 h of self-reported sleep. Participants were prompted to set a goal related to healthy eating/physical activity and had the opportunity to set another goal on any topic of interest. Those who set a goal related to improving sleep or who discussed a desire to improve sleep during coaching were classified as having an interest in sleep improvement. Analyses utilized multivariable models to evaluate factors contributing to short sleep and interest in sleep improvement. We present our process of discussing results with community leaders and health workers. RESULTS A total of 485 women of color participated in the study. Among these, 199 (41%) reported short sleep duration. In adjusted models, Blacks/African Americans and Native Hawaiians/Pacific Islanders had higher odds of reporting < 7 h of sleep than Hispanics/Latinas. Depression symptoms and self-reported stress management scores were significantly associated with short sleep duration. Interest in sleep improvement was noted in the wellness coaching notes of 52 women (10.7%); sleep was the most common focus of goals not related to healthy eating/physical activity. African Immigrants/Refugees and African Americans were less likely to report interest in sleep improvement. Community leaders and health workers reported lack of awareness of the role of sleep in health and discussed challenges to obtaining adequate sleep in their communities. CONCLUSION Despite the high prevalence of short sleep duration, interest in sleep improvement was generally low. This study highlights a discrepancy between need and interest, and our process of community engagement, which can inform intervention development for addressing sleep duration among diverse women.
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Affiliation(s)
- Sara E Simonsen
- University of Utah College of Nursing, 10 South 2000 East Rm 4200, Salt Lake City, UT, 84112, USA.
| | - Grant R Sunada
- Department of Family and Preventive Medicine, Division of Public Health, 375 Chipeta Wy Suite A, Salt Lake City, Utah, 84108, USA
| | - Kathleen Digre
- Departments of Neurology, Ophthalmology, and Obstetrics and Gynecology, University of Utah, 175 N Medical Dr E Rm 5001, Salt Lake City, UT, 84132, USA
| | - Louisa A Stark
- University of Utah Genetic Science Learning Ctr, 515 E 100 S Rm 300, Salt Lake City, Utah, 84112, USA
| | | | - Ed Napia
- Urban Indian Center of Salt Lake, 120 West 1300 South, Salt Lake City, Utah, 84115, USA
| | - Fahina Tavake-Pasi
- National Tongan American Society, 3007 South West Temple #H, Salt Lake City, Utah, 84115, USA
| | - Jeannette Villalta
- Hispanic Health Care Task Force, 5280 Commerce Dr. Suite E140, Murray, Utah, 84107, USA
| | - Doriena Lee
- Calvary Baptist Church, 1090 South State Street, Salt Lake City, Utah, 84111, USA
| | - France Davis
- Calvary Baptist Church, 1090 South State Street, Salt Lake City, Utah, 84111, USA
| | - Ana Sanchez-Birkhead
- University of Utah College of Nursing, 10 South 2000 East Rm 4200, Salt Lake City, UT, 84112, USA
| | - B Heather Brown
- University of Utah Center for Clinical and Translational Science, 515 East 100 South, Salt Lake City, Utah, 84102, USA
| | - Kelly G Baron
- Department of Family and Preventive Medicine, Division of Public Health, 375 Chipeta Wy Suite A, Salt Lake City, Utah, 84108, USA
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Heinsberg LW, Carlson JC, Pomer A, Cade BE, Naseri T, Reupena MS, Weeks DE, McGarvey ST, Redline S, Hawley NL. Correlates of daytime sleepiness and insomnia among adults in Samoa. SLEEP EPIDEMIOLOGY 2022; 2:100042. [PMID: 36338277 PMCID: PMC9635619 DOI: 10.1016/j.sleepe.2022.100042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Objective To describe daytime sleepiness and insomnia among adults in Samoa and identify modifiable factors associated with these measures. Design/setting Cross-sectional analysis of data from the Soifua Manuia ("Good Health") study (n = 519, 55.1% female); Upolu island, Samoa. Methods Daytime sleepiness and insomnia were assessed with the Epworth Sleepiness Scale (ESS) and the Women's Health Initiative Insomnia Rating Scale (WHIIRS), respectively. Detailed physical, sociodemographic, and behavioral factors were collected. Sleep measures were characterized using multiple linear regression with backwards elimination and a bootstrap stability investigation. Results Excessive daytime sleepiness (ESS>10) and insomnia (WHIIRS>10) were reported by 20% and 6.3% of the sample, respectively. ESS scores were higher in individuals reporting more physical activity (Estimate=1.88; 95% CI=1.12 to 2.75), higher material wealth (0.18; 0.09 to 0.28), and asthma (2.85; 1.25 to 4.51). ESS scores were lower in individuals residing in periurban versus urban regions (-1.43; -2.39 to -0.41), reporting no work versus day shift work (-2.26; -3.07 to -1.41), and reporting greater perceived stress (-0.14; -0.23 to -0.06). WHIIRS scores were lower in individuals reporting "other" shift work (split/irregular/on-call/rotating) versus day shift work (-1.96; -2.89 to -1.14) and those who perceived their village's wealth to be poor/average versus wealthy (-0.94; -1.50 to -0.34). Conclusions Participants had a generally higher prevalence of excessive daytime sleepiness, but lower prevalence of insomnia, compared with individuals from high-income countries. Factors associated with sleep health differed compared with prior studies, emphasizing potential cultural/environmental differences and the need for targeted interventions to improve sleep health in this setting.
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Affiliation(s)
- Lacey W. Heinsberg
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Corresponding author at: Department of Human Genetics, School of Public Health, University of Pittsburgh, Public Health 3102A, 130 De Soto Street, Pittsburgh, PA 15261. (L.W. Heinsberg)
| | - Jenna C. Carlson
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Alysa Pomer
- Center for Surgery and Public Health, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Brian E. Cade
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | | | | | - Daniel E. Weeks
- Department of Human Genetics, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Stephen T. McGarvey
- International Health Institute and Department of Epidemiology, School of Public Health, and Department of Anthropology, Brown University, Providence, Rhode Island, USA
| | - Susan Redline
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, Massachusetts, USA
| | - Nicola L. Hawley
- Department of Chronic Disease Epidemiology, Yale University School of Public Health, New Haven, Connecticut, USA
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Ogugu EG, Catz SL, Bell JF, Drake C, Bidwell JT, Gangwisch JE. The Association Between Habitual Sleep Duration and Blood Pressure Control in United States (US) Adults with Hypertension. Integr Blood Press Control 2022; 15:53-66. [PMID: 35642173 PMCID: PMC9148584 DOI: 10.2147/ibpc.s359444] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 05/17/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose This study examined the relationship between habitual sleep duration and blood pressure (BP) control in adults with hypertension. Methods This cross-sectional study used data of 5163 adults with hypertension obtained from the 2015–2018 National Health and Nutrition Examination Survey (NHANES). Multivariable logistic regression was used to analyze the association between habitual sleep duration and BP control. Habitual sleep duration was self-reported and defined as the amount of sleep usually obtained in a night or main sleep period during weekdays or workdays. It was categorized as <6, 6 - <7, 7–9, and >9 hours. BP control was defined as average systolic BP <130mmHg and diastolic BP <80mmHg. Results Results from the fully adjusted models show that among all adults with hypertension, habitual sleep duration of <6 hours night/main sleep period was associated with reduced odds of BP control (OR = 0.53, 95% CI: 0ss.37–0.76, P = 0.001) when compared to 7–9 hours. In the subpopulation of adults who were on antihypertensive medication, those with a sleep duration of <6 hours had lower odds of BP control than those with a sleep duration of 7–9 hours (OR = 0.53, 95% CI: 0.36–0.77, P = 0.002). No significant differences were noted in all adults with hypertension and in the subpopulation of those on antihypertensive medication in BP control between the reference sleep duration group (7–9 hours) and the 6 - <7 or >9 hours groups. There were no significant differences across age groups or gender in the relationship between habitual sleep duration and BP control. Conclusion Sleep duration of <6 hours is associated with reduced odds of hypertension control. These significant findings indicate that interventions to support adequate habitual sleep duration may be a promising addition to the current hypertension management guidelines.
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Affiliation(s)
- Everlyne G Ogugu
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, CA, USA
| | - Sheryl L Catz
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, CA, USA
| | - Janice F Bell
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, CA, USA
| | - Christiana Drake
- Department of Statistics, University of California Davis, Davis, CA, USA
| | - Julie T Bidwell
- Betty Irene Moore School of Nursing, University of California Davis, Sacramento, CA, USA
| | - James E Gangwisch
- Department of Psychiatry, Columbia University, New York City, NY, USA
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Kanaya AM, Hsing AW, Panapasa SV, Kandula NR, Araneta MRG, Shimbo D, Wang P, Gomez SL, Lee J, Narayan KMV, Mau MKLM, Bose S, Daviglus ML, Hu FB, Islam N, Jackson CL, Kataoka-Yahiro M, Kauwe JSK, Liu S, Ma GX, Nguyen T, Palaniappan L, Setiawan VW, Trinh-Shevrin C, Tsoh JY, Vaidya D, Vickrey B, Wang TJ, Wong ND, Coady S, Hong Y. Knowledge Gaps, Challenges, and Opportunities in Health and Prevention Research for Asian Americans, Native Hawaiians, and Pacific Islanders: A Report From the 2021 National Institutes of Health Workshop. Ann Intern Med 2022; 175:574-589. [PMID: 34978851 PMCID: PMC9018596 DOI: 10.7326/m21-3729] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Asian Americans (AsA), Native Hawaiians, and Pacific Islanders (NHPI) comprise 7.7% of the U.S. population, and AsA have had the fastest growth rate since 2010. Yet the National Institutes of Health (NIH) has invested only 0.17% of its budget on AsA and NHPI research between 1992 and 2018. More than 40 ethnic subgroups are included within AsA and NHPI (with no majority subpopulation), which are highly diverse culturally, demographically, linguistically, and socioeconomically. However, data for these groups are often aggregated, masking critical health disparities and their drivers. To address these issues, in March 2021, the National Heart, Lung, and Blood Institute, in partnership with 8 other NIH institutes, convened a multidisciplinary workshop to review current research, knowledge gaps, opportunities, barriers, and approaches for prevention research for AsA and NHPI populations. The workshop covered 5 domains: 1) sociocultural, environmental, psychological health, and lifestyle dimensions; 2) metabolic disorders; 3) cardiovascular and lung diseases; 4) cancer; and 5) cognitive function and healthy aging. Two recurring themes emerged: Very limited data on the epidemiology, risk factors, and outcomes for most conditions are available, and most existing data are not disaggregated by subgroup, masking variation in risk factors, disease occurrence, and trajectories. Leveraging the vast phenotypic differences among AsA and NHPI groups was identified as a key opportunity to yield novel clues into etiologic and prognostic factors to inform prevention efforts and intervention strategies. Promising approaches for future research include developing collaborations with community partners, investing in infrastructure support for cohort studies, enhancing existing data sources to enable data disaggregation, and incorporating novel technology for objective measurement. Research on AsA and NHPI subgroups is urgently needed to eliminate disparities and promote health equity in these populations.
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Affiliation(s)
- Alka M Kanaya
- University of California, San Francisco, San Francisco, California (A.M.K., S.L.G., T.N., J.Y.T.)
| | - Ann W Hsing
- Stanford University, Stanford, California (A.W.H., P.W., L.P.)
| | | | | | | | - Daichi Shimbo
- Columbia University Irving Medical Center, New York, New York (D.S.)
| | - Paul Wang
- Stanford University, Stanford, California (A.W.H., P.W., L.P.)
| | - Scarlett L Gomez
- University of California, San Francisco, San Francisco, California (A.M.K., S.L.G., T.N., J.Y.T.)
| | - Jinkook Lee
- University of Southern California, Los Angeles, California (J.L., V.W.S.)
| | | | | | - Sonali Bose
- Icahn School of Medicine at Mount Sinai, New York, New York (S.B., B.V.)
| | | | - Frank B Hu
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts (F.B.H.)
| | - Nadia Islam
- New York University Grossman School of Medicine, New York, New York (N.I., C.T.)
| | - Chandra L Jackson
- National Institute of Environmental Health Sciences, National Institutes of Health, Bethesda, Maryland (C.L.J.)
| | | | | | - Simin Liu
- Brown University, Providence, Rhode Island (S.L.)
| | - Grace X Ma
- Temple University, Philadelphia, Pennsylvania (G.X.M.)
| | - Tung Nguyen
- University of California, San Francisco, San Francisco, California (A.M.K., S.L.G., T.N., J.Y.T.)
| | | | - V Wendy Setiawan
- University of Southern California, Los Angeles, California (J.L., V.W.S.)
| | - Chau Trinh-Shevrin
- New York University Grossman School of Medicine, New York, New York (N.I., C.T.)
| | - Janice Y Tsoh
- University of California, San Francisco, San Francisco, California (A.M.K., S.L.G., T.N., J.Y.T.)
| | | | - Barbara Vickrey
- Icahn School of Medicine at Mount Sinai, New York, New York (S.B., B.V.)
| | - Thomas J Wang
- University of Texas Southwestern Medical Center, Dallas, Texas (T.J.W.)
| | - Nathan D Wong
- University of California, Irvine, Irvine, California (N.D.W.)
| | - Sean Coady
- National Heart, Lung, and Blood Institute, Bethesda, Maryland (S.C., Y.H.)
| | - Yuling Hong
- National Heart, Lung, and Blood Institute, Bethesda, Maryland (S.C., Y.H.)
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10
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Ogugu EG, Catz SL, Bell JF, Drake C, Bidwell JT, Gangwisch JE. Factors associated with habitual sleep duration in US adults with hypertension: a cross-sectional study of the 2015-2018 National Health and Nutrition Examination Survey. BMC Public Health 2022; 22:43. [PMID: 34991527 PMCID: PMC8739698 DOI: 10.1186/s12889-021-12465-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 12/20/2021] [Indexed: 12/22/2022] Open
Abstract
Background The relationship between inadequate sleep duration and hypertension risk has been established in the general population, but there is a gap in the literature on predictors of habitual sleep duration in adults with hypertension. This study examined factors associated with habitual sleep duration among adults with hypertension in the United States (US). Methods Data of 5660 adults with hypertension were obtained by combining the 2015–2018 cycles of the National Health and Nutrition Examination Survey (NHANES). Survey weighted multinomial logistic regression models were fit to examine factors associated with short (< 7 h) and long (> 9 h) sleep duration with adequate sleep duration (7–9 h) as the reference. Results The prevalence of self-reported adequate sleep duration was 65.7%, while short sleep duration was 23.6%, and long sleep duration 10.7%. Short sleep duration (compared to adequate sleep duration) was positively associated with history of seeking help for sleeping difficulties (relative risk ratio [RRR], 1.25; 95% confidence interval [CI], 1.02–1.53), Non-Hispanic Black race/ethnicity (RRR, 2.08; 95% CI, 1.61–2.67), working ≥45 h/week (RRR, 1.81; 95% CI, 1.32–2.48), and negatively associated with older age ≥ 65 years (RRR, 0.63; 95% CI, 0.45–0.91) and female gender (RRR, 0.70; 95% CI, 0.56–0.88). Long sleep duration was positively associated with female gender (RRR, 1.24; 95% CI, 1.001–1.54), chronic kidney disease (RRR, 1.48; 95% CI, 1.14–1.92), moderate depressive symptoms (RRR, 1.62; 95% CI, 1.08–2.44), moderately severe to severe depressive symptoms (RRR, 1.89; 95% CI, 1.05–3.43), being in retirement (RRR, 3.46; 95% CI, 2.18–5.49), and not working due to health reasons (RRR, 4.87; 95% CI, 2.89–8.22) or other reasons (RRR, 3.29; 95% CI, 1.84–5.88). Conclusion This population-based study identified factors independently associated with habitual sleep duration in adults with hypertension. These included help-seeking for sleeping difficulty, gender, age, chronic kidney disease, depressive symptoms, race/ethnicity, and employment status. These findings can help in the development of tailored approaches for promoting adequate sleep duration in adults with hypertension. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-12465-2.
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Affiliation(s)
- Everlyne G Ogugu
- Betty Irene Moore School of Nursing, University of California, Davis 2570 48th Street, Sacramento, CA, 95817, USA.
| | - Sheryl L Catz
- Betty Irene Moore School of Nursing, University of California, Davis 2570 48th Street, Sacramento, CA, 95817, USA
| | - Janice F Bell
- Betty Irene Moore School of Nursing, University of California, Davis 2570 48th Street, Sacramento, CA, 95817, USA
| | - Christiana Drake
- Department of Statistics, University of California, Davis 399 Crocker Ln, Davis, CA, 95616, USA
| | - Julie T Bidwell
- Betty Irene Moore School of Nursing, University of California, Davis 2570 48th Street, Sacramento, CA, 95817, USA
| | - James E Gangwisch
- Department of Psychiatry, Columbia University, 1051 Riverside Drive, New York, NY, 10032, USA
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11
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Wang ML, Narcisse MR, Alatorre S, Kozak AT, McElfish PA. Neighborhood social cohesion and physical activity and obesity outcomes among Native Hawaiian and Pacific Islander individuals. Obesity (Silver Spring) 2022; 30:249-256. [PMID: 34910366 PMCID: PMC11201332 DOI: 10.1002/oby.23298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 08/25/2021] [Accepted: 08/29/2021] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Native Hawaiian and Pacific Islander (NHPI) individuals report high obesity rates and low physical activity (PA) levels. This study examined associations between neighborhood social cohesion, obesity, and PA among NHPI adults. METHODS Cross-sectional data from the 2014 NHPI National Health Interview Survey were analyzed. Social cohesion was assessed using a summative scale and categorized as low, medium, and high. PA was measured via self-report and categorized as insufficiently active (0-149 min/wk) or sufficiently active (150+ min/wk). Obesity status was based on self-reported height and weight measures converted into standard BMI categories. Multivariable logistic regression models estimated odds of obesity and sufficient PA associated with social cohesion level. RESULTS The study sample included n = 2,590 NHPI adults. Compared with those in low social cohesion neighborhoods, participants in high social cohesion neighborhoods had increased sufficient PA odds (odds ratio [OR] = 1.59, 95% CI: 1.19-2.12; p = 0.003) and decreased obesity odds (OR = 0.57, 95% CI: 0.40-0.83; p = 0.005). No associations were observed between social cohesion and obesity and PA outcomes comparing individuals in medium versus low social cohesion neighborhoods. CONCLUSIONS High social cohesion was associated with reduced obesity odds and increased sufficient PA odds. Findings highlight the importance of enhancing social connectivity as a potential strategy to promote PA and healthy weight among NHPI individuals.
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Affiliation(s)
- Monica L. Wang
- Boston University School of Public Health, Department of Community Health Sciences, 715 Albany Street, Boston, Massachusetts 02118 USA
- Boston University Center for Antiracist Research, 1 Silber Way, Boston, Massachusetts 02215 USA
- Harvard T.H. Chan School of Public Health, Department of Health Policy and Management, 677 Huntington Avenue, Boston, Massachusetts 02115 USA
| | - Marie-Rachelle Narcisse
- University of Arkansas for Medical Sciences Northwest, College of Medicine, 1125 N. College Avenue, Fayetteville, Arkansas 72703 USA
| | - Selenne Alatorre
- Boston University School of Public Health, Department of Community Health Sciences, 715 Albany Street, Boston, Massachusetts 02118 USA
| | - Andrea T. Kozak
- Department of Psychology, Oakland University, 654 Pioneer Drive. Rochester, Michigan 48309 USA
| | - Pearl A. McElfish
- University of Arkansas for Medical Sciences Northwest, College of Medicine, 1125 N. College Avenue, Fayetteville, Arkansas 72703 USA
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12
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Abukanna AMA, Alanazi BFA, Alanazi STA, ALHarbi EAM, Alanazi TMM. Sleep Deficiency as a Risk Factor for Hypertension: A Systematic Review. PHARMACOPHORE 2022. [DOI: 10.51847/irvyhqbvik] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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13
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Yuan M, Wu Z, Luo B, Sha Y, Zhang H, Bi M, Fang Y. Gender-specified mediation of depression between sleep quality and short-term memory in older adults: Study in a semi-closed Island of Xiamen, China. Int J Geriatr Psychiatry 2021; 36:1514-1523. [PMID: 33899959 DOI: 10.1002/gps.5559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 04/09/2021] [Accepted: 04/17/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND Both the quality of sleep and depression impact short-term memory (STM) while they influence each other. However, the underlying mechanisms are not yet clear. Herein, we aimed to explore the mediating effect of depression between sleep quality and STM in older adults and further test the gender differences in this relationship. METHODS A cluster sampling survey was carried out among 903 residents that were aged 60+ years in a semi-closed island of Xiamen, China, in 2019. The subjects' sleep quality and depression were measured using the Pittsburgh Sleep Quality Index (PSQI) and the 15-item Geriatric Depression Scale (GDS-15), respectively. The three-item recall test was utilized to measure STM function. Mediation analyses were performed using the structural equation model and bias-corrected bootstrap method. Next, the Wald-test was utilized to determine gender differences in the pathway. RESULTS Overall, 355 men and 508 women, with a mean age of 69.55 and 70.97, respectively, had valid data on the main variables. Depression was found to mediate the effect of sleep quality on STM (a*b = -0.076, p < 0.05). Interestingly, while this indirect effect existed in the female group (af *bf = -0.126, p < 0.05), it did not in the male group (am *bm = 0.017, p = 0.677). The Wald-test indicated no gender differences in the pathway from sleep quality to depression (p = 0.303). However, the pathway from depression to STM function was found to be significantly stronger for females than males (p = 0.0198). CONCLUSION Higher sleep quality was found to be associated with improved STM function. Furthermore, the association was found to be regulate indirectly by lower depressive symptoms for females, but directly for males. Therefore, appropriate psychological interventions may be beneficial to the maintenance of STM for older adults, particularly for women.
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Affiliation(s)
- Manqiong Yuan
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China.,Department of Preventive Medicine, Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
| | - Zhilin Wu
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Bei Luo
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Yude Sha
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Hemin Zhang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China
| | - Min Bi
- Department of Neurology, The First Affiliated Hospital of Xiamen University, Xiamen, Fujian, China.,Graduate School of Fujian Medical University, Fuzhou, Fujian, China
| | - Ya Fang
- State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, School of Public Health, Xiamen University, Xiamen, China.,Department of Preventive Medicine, Key Laboratory of Health Technology Assessment of Fujian Province, School of Public Health, Xiamen University, Xiamen, China
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14
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McElfish PA, Narcisse MR, Selig JP, Felix HC, Scott AJ, Long CR. Effects of Race and Poverty on Sleep Duration: Analysis of Patterns in the 2014 Native Hawaiian and Pacific Islander National Health Interview Survey and General National Health Interview Survey Data. J Racial Ethn Health Disparities 2021; 8:837-843. [PMID: 32815121 PMCID: PMC9810133 DOI: 10.1007/s40615-020-00841-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 07/07/2020] [Accepted: 08/04/2020] [Indexed: 01/05/2023]
Abstract
BACKGROUND There are health concerns associated with unhealthy sleep duration. A growing body of evidence indicates that there are disparities in sleep duration based upon race/ethnicity and socioeconomic status. Prior studies have suffered from inadequate measures of poverty and have not included Native Hawaiians and Pacific Islanders (NHPI). METHODS Using the 2014 National Health Interview Survey (NHIS) and the 2014 NHPI-NHIS, the effect of race/ethnicity and poverty was examined for associations with sleep duration. RESULTS Significant differences among race/ethnicity groups and sleep duration were found in adjusted associations. Compared with Whites, NHPIs and Blacks were twice as likely to experience very short sleep; NHPI, Hispanic, and Blacks were more likely to experience short sleep; Blacks were also more likely to experience long sleep. Asians were less likely to experience unhealthy sleep (very short, short, or long sleep). Persons living in poverty were significantly more likely to experience very short sleep compared with persons not living in poverty. CONCLUSION This is the first population-based study that has examined the relationship between sleep duration and poverty with a large sample that included NHPI in relation to other races/ethnicities. The difference in sleep duration between NHPI and Asians provides a strong rationale for not aggregating Asian and NHPI data in population-based studies.
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Affiliation(s)
- Pearl Anna McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA.
| | - Marie-Rachelle Narcisse
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - James P Selig
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Holly C Felix
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Aaron J Scott
- Office of Community Health & Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
| | - Christopher R Long
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, AR, USA
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15
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Ahn S, Lobo JM, Logan JG, Kang H, Kwon Y, Sohn MW. A scoping review of racial/ethnic disparities in sleep. Sleep Med 2021; 81:169-179. [PMID: 33713923 DOI: 10.1016/j.sleep.2021.02.027] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 02/08/2021] [Accepted: 02/11/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND Despite remarkable achievements in ensuring health equity, racial/ethnic disparities in sleep still persist and are emerging as a major area of concern. Accumulating evidence has not yet been well characterized from a broad perspective. We conducted a scoping review of studies on sleep disparities by race/ethnicity to summarize characteristics of existing studies and identify evidence gaps. METHODS We searched PubMed, CINAHL, PsycINFO, and Web of Science databases for studies of racial/ethnic disparities in sleep. Studies that met inclusion criteria were retrieved and organized in a data charting form by study design, sleep measuring methods, sleep features, and racial/ethnic comparisons. RESULTS One hundred sixteen studies were included in this review. Most studies focused on disparities between Whites and Blacks. Disproportionately fewer studies examined disparities for Hispanic, Asian, and other racial/ethnic groups. Self-reported sleep was most frequently used. Sleep duration, overall sleep quality, and sleep disordered breathing were frequently studied, whereas other features including sleep efficiency, latency, continuity, and architecture were understudied, particularly in racial minority groups in the US. Current study findings on racial/ethnic disparities in most of sleep features is mixed and inconclusive. CONCLUSIONS This review identified significant evidence gaps in racial/ethnic disparities research on sleep. Our results suggest a need for more studies examining diverse sleep features using standardized and robust measuring methods for more valid comparisons of sleep health in diverse race/ethnicity groups.
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Affiliation(s)
- Soojung Ahn
- School of Nursing, University of Virginia, Charlottesville, VA, USA
| | - Jennifer M Lobo
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - Jeongok G Logan
- School of Nursing, University of Virginia, Charlottesville, VA, USA
| | - Hyojung Kang
- College of Applied Health Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Younghoon Kwon
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Min-Woong Sohn
- Department of Health Management and Policy, College of Public Health, University of Kentucky, Lexington, KY, USA.
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16
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McElfish PA, Andersen JA, Felix HC, Purvis RS, Rowland B, Scott AJ, Chatrathi M, Long CR. Relationship between sleep duration and quality and glycated hemoglobin, body mass index, and self-reported health in Marshallese adults. Sleep Health 2021; 7:332-338. [PMID: 33707104 DOI: 10.1016/j.sleh.2021.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 01/22/2021] [Accepted: 01/23/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To document sleep duration and sleep quality among a sample of Marshallese adults and to examine if sleep duration and quality are associated with type 2 diabetes, body mass index (BMI), and self-reported health in the Marshallese population. DESIGN Cross-sectional analysis of a staff-administered survey. SETTING Thirty Marshallese churches in Arkansas and Oklahoma. PARTICIPANTS The study includes 378 Marshallese participants, 56.6% female, with a mean age of 42.4 years (±11.6). Recruitment was limited to participants who were considered overweight, with a BMI >25 kg/m2. MEASURES Staff-administered surveys were used to collect data on sleep duration, sleep quality, and self-reported health. Clinical measures were collected by trained research personnel using standard tools and protocols. Kruskal-Wallis tests, Spearman's correlations, and nonparametric tests of trends were used to evaluate differences in HbA1c, BMIc, and self-reported health by sleep duration and quality. Multivariable analyses were used to test the associations, controlling for sociodemographic factors. RESULTS Fifty-four percent of the participants reported something other than normal sleep duration and 52.4% reported at least 1 night of difficult or interrupted sleep in the previous 2-week period. Longer sleep duration was associated with lower HbA1c and poorer sleep quality was associated with higher HbA1c. Poor sleep quality was associated with lower self-reported health. However, neither sleep duration nor quality was associated with BMI. The associations were found independent of sociodemographic factors. CONCLUSION This is the first study to document sleep duration and sleep quality, as well as the first study to examine the relationship between sleep and HbA1c, BMI, and self-reported health in Marshallese adults with a BMI >25 kg/m2. This research will be used to help develop sleep interventions to address type 2 diabetes health disparities in the Marshallese community.
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Affiliation(s)
- Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas, USA.
| | - Jennifer A Andersen
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas, USA
| | - Holly C Felix
- Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Rachel S Purvis
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas, USA
| | - Brett Rowland
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas, USA
| | - Aaron J Scott
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas, USA
| | - Meena Chatrathi
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas, USA
| | - Christopher R Long
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas, USA
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17
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Liew SC, Aung T. Sleep deprivation and its association with diseases- a review. Sleep Med 2020; 77:192-204. [PMID: 32951993 DOI: 10.1016/j.sleep.2020.07.048] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/08/2020] [Accepted: 07/27/2020] [Indexed: 01/02/2023]
Abstract
Sleep deprivation, a consequence of multiple health problems or a cause of many major health risks, is a significant public health concern in this era. In the recent years, numerous reports have been added to the literature to provide explanation and to answer previously unanswered questions on this important topic but comprehensive updates and reviews in this aspect remain scarce. The present study identified 135 papers that investigated the association between sleep deprivation and health risks, including cardiovascular, respiratory, neurological, gastrointestinal, immunology, dermatology, endocrine, and reproductive health. In this review, we aimed to provide insight into the association between sleep deprivation and the development of diseases. We reviewed the latest updates available in the literature and particular attention was paid to reports that detailed all possible causal relationships involving both extrinsic and intrinsic factors that may be relevant to this topic. Various mechanisms by which sleep deprivation may affect health were presented and discussed, and this review hopes to serve as a platform for ideas generation for future research.
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Affiliation(s)
- Siaw Cheok Liew
- Department of Clinical Competence, Perdana University-Royal College of Surgeons in Ireland, Kuala Lumpur, Malaysia.
| | - Thidar Aung
- Department of Biochemistry, Perdana University-Royal College of Surgeons in Ireland, Kuala Lumpur, Malaysia
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18
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Jackson CL, Walker JR, Brown MK, Das R, Jones NL. A workshop report on the causes and consequences of sleep health disparities. Sleep 2020; 43:zsaa037. [PMID: 32154560 PMCID: PMC7420527 DOI: 10.1093/sleep/zsaa037] [Citation(s) in RCA: 113] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 01/16/2020] [Indexed: 01/10/2023] Open
Abstract
Sleep deficiencies, which include insufficient or long sleep duration, poor sleep quality, and irregular timing of sleep, are disproportionately distributed among populations that experience health disparities in the United States. Sleep deficiencies are associated with a wide range of suboptimal health outcomes, high-risk health behaviors, and poorer overall functioning and well-being. This report focuses on sleep health disparities (SHDs), which is a term defined as differences in one or more dimensions of sleep health on a consistent basis that adversely affect designated disadvantaged populations. SHDs appear to share many of the same determinants and causal pathways observed for health outcomes with well-known disparities. There also appears to be common behavioral and biological mechanisms that connect sleep with poorer health outcomes, suggesting a link between SHDs and other health disparities observed within these designated populations. In 2018, the National Institute on Minority Health and Health Disparities, the National Heart, Lung, and Blood Institute, and the Office of Behavioral and Social Sciences Research convened a workshop with experts in sleep, circadian rhythms, and health disparities to identify research gaps, challenges, and opportunities to better understand and advance research to address SHDs. The major strategy to address SHDs is to promote integration between health disparity causal pathways and sleep and circadian-related mechanisms in research approaches and study designs. Additional strategies include developing a comprehensive, integrative conceptual model, building transdisciplinary training and research infrastructure, and designing as well as testing multilevel, multifactorial interventions to address SHDs.
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Affiliation(s)
- Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC
- Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD
| | - Jenelle R Walker
- Center for Translation Research and Implementation Science, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Marishka K Brown
- Division of Lung Diseases, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Rina Das
- Division of Extramural Scientific Programs, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD
| | - Nancy L Jones
- Division of Extramural Scientific Programs, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD
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19
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Social Epidemiology of Sleep: Extant Evidence and Future Directions. CURR EPIDEMIOL REP 2019. [DOI: 10.1007/s40471-019-00219-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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20
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Johnson DA, Jackson CL, Williams NJ, Alcántara C. Are sleep patterns influenced by race/ethnicity - a marker of relative advantage or disadvantage? Evidence to date. Nat Sci Sleep 2019; 11:79-95. [PMID: 31440109 PMCID: PMC6664254 DOI: 10.2147/nss.s169312] [Citation(s) in RCA: 207] [Impact Index Per Article: 41.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2019] [Accepted: 05/09/2019] [Indexed: 12/25/2022] Open
Abstract
Sleep is a fundamental necessity of life. However, sleep health and sleep disorders are not equitably distributed across racial/ethnic groups. In fact, growing research consistently demonstrates that racial/ethnic minorities are more likely to experience, for instance, shorter sleep durations, less deep sleep, inconsistent sleep timing, and lower sleep continuity in comparison to Whites. However, racial/ethnic disparities in reports of sleepiness and sleep complaints are inconsistent. Racial/ethnic groups have significant heterogeneity, yet within-group analyses are limited. Among the few published within-group analyses, there are differences in sleep between non-US-born and US-born racial/ethnic groups, but the group with the more favorable sleep profile is consistent for non-US-born Latinos compared to US-born Latinos and Whites but unclear for other racial/ethnic minority groups. These sleep health disparities are a significant public health problem that should garner support for more observational, experimental, intervention, and policy/implementation research. In this review, we 1) summarize current evidence related to racial/ethnic disparities in sleep health and within-group differences, focusing on the sleep of the following racial/ethnic minority categories that are defined by the United States Office of Management and Budget as: American Indian/Alaska Native, Asian, African American/Black, Hispanic/Latino, and Native Hawaiian/Pacific Islander; 2) discuss measurement challenges related to investigating sleep health disparities; 3) discuss potential contributors to sleep health disparities; 4) present promising interventions to address sleep health disparities; and 5) discuss future research directions on intersectionality and sleep health.
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Affiliation(s)
- Dayna A Johnson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
| | - Chandra L Jackson
- Department of Health and Human Services, Epidemiology Branch, National Institute on Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
- Department of Health and Human Services, Intramural Program, National Institute of Minority Health and Health Disparities, Bethesda, MD, USA
| | - Natasha J Williams
- Department of Population Health, New York University School of Medicine, Center for Healthful Behavior Change, New York, NY, USA
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21
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Lawson JL, Wiedemann AA, Carr MM, Ivezaj V, Duffy AJ, Grilo CM. Examining Sleep Quality Following Sleeve Gastrectomy Among Patients with Loss-of-Control Eating. Obes Surg 2019; 29:3264-3270. [PMID: 31197602 DOI: 10.1007/s11695-019-03981-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Sleep is associated with post-bariatric surgical outcomes; however, little is known about sleep in bariatric patients with loss-of-control (LOC) eating, a consistent predictor of poorer weight outcomes. This study examined sleep quality and clinical correlates in sleeve gastrectomy patients with LOC eating. METHODS Participants (N = 145) were treatment-seeking post-operative sleeve gastrectomy patients with LOC eating. Eating-disorder features were assessed with the Eating Disorder Examination-Bariatric Surgery Version Interview (EDE-BSV) and participants completed established measures assessing sleep, health-related quality of life, perceived stress, depression, and night eating. RESULTS 58.6% of participants were characterized with "poor" sleep. Poor sleep quality was significantly associated with greater eating-disorder psychopathology, physical and mental functioning, night eating, perceived stress, and less % excess weight loss (EWL); these findings remained significant after controlling for %EWL and race. Regression analyses, adjusting for correlated variables, revealed that sleep quality significantly predicted mental functioning. CONCLUSIONS Poor sleep quality was common among post-operative sleeve gastrectomy patients with LOC eating. Sleep quality was significantly associated with eating-disorder psychopathology, less post-operative weight loss, and psychosocial and physical functioning problems. These findings suggest the importance of assessment and treatment of sleep problems following sleeve gastrectomy. CLINICAL TRIAL REGISTRATION ClinicalTrials.gov identifier NCT02259322.
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Affiliation(s)
- Jessica L Lawson
- Program for Obesity, Weight, and Eating Research, Psychiatry Department, Yale School of Medicine, 301 Cedar Street, New Haven, CT, 06519, USA.
| | - Ashley A Wiedemann
- Program for Obesity, Weight, and Eating Research, Psychiatry Department, Yale School of Medicine, 301 Cedar Street, New Haven, CT, 06519, USA
| | - Meagan M Carr
- Program for Obesity, Weight, and Eating Research, Psychiatry Department, Yale School of Medicine, 301 Cedar Street, New Haven, CT, 06519, USA
| | - Valentina Ivezaj
- Program for Obesity, Weight, and Eating Research, Psychiatry Department, Yale School of Medicine, 301 Cedar Street, New Haven, CT, 06519, USA
| | | | - Carlos M Grilo
- Program for Obesity, Weight, and Eating Research, Psychiatry Department, Yale School of Medicine, 301 Cedar Street, New Haven, CT, 06519, USA.,Yale University, New Haven, CT, USA
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22
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Makarem N, Shechter A, Carnethon MR, Mullington JM, Hall MH, Abdalla M. Sleep Duration and Blood Pressure: Recent Advances and Future Directions. Curr Hypertens Rep 2019; 21:33. [PMID: 30953237 DOI: 10.1007/s11906-019-0938-7] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW This review discusses the recent literature on subjectively and objectively assessed sleep duration in relation to hypertension risk and out-of-clinic blood pressure (BP) measures and highlights critical areas for future research. RECENT FINDINGS Sleep duration, particularly short sleep, may influence BP through disturbed autonomic balance, hormonal imbalances, increased adiposity and metabolic dysfunction, and disrupted circadian rhythms. Observational studies indicate that short and long sleep are associated with hypertension risk, reduced nocturnal dipping, and elevated morning BP, but evidence is stronger for short sleep. Experimental sleep restriction increases BP, while sleep extension may lower BP in prehypertensive individuals. Women and racial/ethnic minorities are more prone to the detrimental effects of short sleep on BP. Additional studies are warranted to clarify the association of objectively assessed sleep with BP level and diurnal pattern and to determine the sex- and race-specific effects of sleep restriction and extension on BP.
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Affiliation(s)
- Nour Makarem
- Department of Medicine, Division of Cardiology, Columbia University Irving Medical Center, 51 Audubon Avenue, 5th floor, Suite 501, New York, NY, 10032, USA
| | - Ari Shechter
- Department of Medicine, Division of Cardiology, Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, 622 West 168th Street, PH 9-321, New York, NY, 10032, USA
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Janet M Mullington
- Department of Neurology, Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA
| | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA
| | - Marwah Abdalla
- Department of Medicine, Division of Cardiology, Center for Behavioral Cardiovascular Health, Columbia University Irving Medical Center, 622 West 168th Street, PH 9-321, New York, NY, 10032, USA.
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23
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McElfish PA, Purvis RS, Esquivel MK, Sinclair KA, Townsend C, Hawley NL, Haggard-Duff LK, Kaholokula JK. Diabetes Disparities and Promising Interventions to Address Diabetes in Native Hawaiian and Pacific Islander Populations. Curr Diab Rep 2019; 19:19. [PMID: 30887399 PMCID: PMC7171975 DOI: 10.1007/s11892-019-1138-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
PURPOSE OF REVIEW The Native Hawaiian and Pacific Islander (NHPI) population is rapidly growing in the USA. NHPIs face significant health disparities and have a high prevalence of diabetes compared to the general US population. RECENT FINDINGS Recent culturally-adapted diabetes interventions have shown promise in addressing these disparities among NHPI communities. The interventions showed success by utilizing a community-based approach that honored NHPIs' collectivist culture, addressed social determinants of health that influence disease control and prevention, and utilized NHPI community health workers (CHWs) and peer educators for key roles in implementation of the intervention. To address health disparities in the NHPI community, much can be learned from existing, successful interventions. Promising interventions share several attributes. The interventions were: culturally adapted using a community-based participatory research approach; addressed specific social determinants of health (i.e., cost of healthy food, transportation, access to health care) that influence disease control and prevention; honored the collectivist culture of NHPI communities by integrating social networks and extended family members; and utilized NHPI community members, including peer educators and CHWs, for intervention implementation. Further investment to scale these interventions for regional and national implementation is needed to address the significant diabetes disparities that NHPIs face.
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Affiliation(s)
- Pearl A McElfish
- College of Medicine, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR, 72703, USA.
| | - Rachel S Purvis
- Office of Community Health and Research, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR, 72703, USA
| | - Monica K Esquivel
- Department of Human Nutrition Food and Animal Sciences, College of Tropical Agriculture and Human Resources, University of Hawaii at Manoa, 1955 East West Road Ag Sci 314 L, Honolulu, HI, 96822, USA
| | - Ka'imi A Sinclair
- College of Nursing, Washington State University, 1100 Olive Way, Suite 1200, Seattle, WA, 98101, USA
| | - Claire Townsend
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawaii at Manoa, 677 Ala Moana Blvd, Suite 1016, Honolulu, HI, 96813, USA
| | - Nicola L Hawley
- Yale School of Public Health, Yale University, 60 College St, New Haven, CT, 06510, USA
| | - Lauren K Haggard-Duff
- College of Nursing, University of Arkansas for Medical Sciences Northwest, 1125 N. College Ave, Fayetteville, AR, 72703, USA
| | - Joseph Keawe'aimoku Kaholokula
- Department of Native Hawaiian Health, John A. Burns School of Medicine, University of Hawaii at Manoa, 677 Ala Moana Blvd, Suite 1016, Honolulu, HI, 96813, USA
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