Perceived stress, recent stressors, and distress in relation to sleep disturbance and duration among middle-aged and older Asian immigrants

Abstract

Objective: This study aimed to examine the associations of perceived stress, stressors, and distress with sleep disturbance and duration among Asian immigrants.

Design/setting/participants: The sample included 400 Asian immigrants aged 50-75 years old recruited from primary care physicians' clinics.

Methods: We fit multivariable regression models to examine the associations of perceived stress, stressors, and distress with self-reported sleep disturbance and duration. We tested effect modifications by language proficiency, years in the United States, acculturative stress, and social support.

Results: A total of 73 (18.3%) participants reported any sleep disturbance, and the average time in bed was 7.25 hours (SD = 1.17). Higher perceived stress (PR = 1.15, 95% CI = 1.06, 1.26), stressors (PR = 1.32, 95% CI = 1.13, 1.59), and distress (PR = 1.36, 95% CI = 1.21, 1.57) were associated with a higher prevalence of any sleep disturbance. These associations were not modified by language proficiency, years in the United States, acculturative stress, and social support. On the other hand, the associations of perceived stress and distress with time in bed were modified by years in the United States. Specifically, higher levels of distress were associated with shorter times in bed only among adults who have resided in the United States for less than 10 years.

Conclusion: Perceived stress, stressors, and distress were associated with a higher prevalence of sleep disturbance. Moreover, perceived stress and distress had stronger associations with times in bed among recent immigrants. Future sleep health research in Asian Americans should consider the important role of stress and distress, especially among recent immigrants.

Keywords: Asian immigrants; Distress; Sleep disturbance; Sleep duration; Stress.