Insomnia Symptoms among African-American Older Adults in Economically Disadvantaged Areas of South Los Angeles

Mohsen Bazargan; Nadia Mian; Sharon Cobb; Roberto Vargas; Shervin Assari

doi:10.3390/brainsci9110306

Insomnia Symptoms among African-American Older Adults in Economically Disadvantaged Areas of South Los Angeles

Brain Sci. 2019 Nov 2;9(11):306. doi: 10.3390/brainsci9110306.

Authors

Mohsen Bazargan^{1

2}, Nadia Mian³, Sharon Cobb⁴, Roberto Vargas^{5

6}, Shervin Assari⁷

Affiliations

¹ Department of Family Medicine, Charles R Drew University of Medicine and Science (CDU), Los Angeles, CA 90059, USA. Mohsenbazargan@cdrewu.edu.
² Department of Family Medicine, University of California, Los Angeles (UCLA), Los Angeles, CA 90095, USA. Mohsenbazargan@cdrewu.edu.
³ Department of Family Medicine, Charles R Drew University of Medicine and Science (CDU), Los Angeles, CA 90059, USA. nadiamian@cdrewu.edu.
⁴ School of Nursing, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA. sharoncobb1@cdrewu.edu.
⁵ Department of Family Medicine, Charles R Drew University of Medicine and Science (CDU), Los Angeles, CA 90059, USA. robertovargas@cdrewu.edu.
⁶ Urban Health Institute, Charles R Drew University of Medicine and Science, Los Angeles, CA 90059, USA. robertovargas@cdrewu.edu.
⁷ Department of Family Medicine, Charles R Drew University of Medicine and Science (CDU), Los Angeles, CA 90059, USA. shervinassari@cdrewu.edu.

Abstract

Background: Although psychosocial and health factors impact insomnia symptoms, less is known about these effects in economically disadvantaged African-American older adults.

Aims: This study investigated social and health determinants of insomnia symptoms among economically disadvantaged African-American older adults.

Methods: This survey enrolled 398 African-American older adults (age ≥ 65 years) from economically disadvantaged areas of South Los Angeles. Gender, age, educational attainment, financial difficulty, number of chronic diseases, self-rated health, pain intensity, and depression were covariates. Total insomnia, insomnia symptoms, and insomnia impact were our outcomes. Linear regression was applied for data analysis.

Results: Based on linear regression, higher financial difficulty (B = 0.48, 95% CI = 0.35-0.61), smoking status (B = 1.64, 95% CI = 0.13-3.16), higher pain intensity (B = 0.39, 95% CI = 0.11-0.67), higher number of chronic diseases (B = 0.34, 95% CI = 0.05-0.64), and more depressive symptoms (B = 0.35, 95% CI = 0.12-0.57) were associated with a higher frequency of insomnia symptoms. Based on a logistic regression model, lower age (B = 0.91, 95% CI = 0.91-1.00) and high financial difficulty (OR = 1.15, 95% CI = 1.08-1.24), pain (OR = 2.08, 95% CI = 1.14-3.80), chronic disease (OR = 1.27, 95% CI = 1.07-1.51) and depression (OR = 2.38, 95% CI = 1.22-4.65) were associated with higher odds of possible clinical insomnia. We also found specific predictors for insomnia symptoms and insomnia impact.

Conclusions: Among African-American older adults in economically disadvantaged areas of South Los Angeles, insomnia symptoms co-occur with other economic, physical, and mental health challenges such as financial difficulty, smoking, multimorbidity, pain, and depression. There is a need to address sleep as a component of care of economically disadvantaged African-American older adults who have multiple social and health challenges.

Keywords: African-Americans; depression; insomnia; older adults; sleep disorder; sleep quality.

Grants and funding

R25 MD007610/MD/NIMHD NIH HHS/United States