Abstract
Objective
To examine racial/ethnic differences in sleep quality and the pain-sleep association
among older adults with osteoarthritis of the knee.
Design
Baseline interview followed by a 7-day microlongitudinal study using accelerometry
and self-reports.
Setting
Participants were community residents in western Alabama and Long Island, NY.
Participants
Ninety-six African Americans (AAs) and 128 non-Hispanic whites (NHWs) with physician-diagnosed
knee osteoarthritis, recruited from a variety of clinical and community settings.
Measurements
Self-reports yielded demographics, body mass index, physical health problems, and
depressive symptoms. Sleep quality was measured for 3 to 7 nights using wrist-worn
accelerometers; pain was self-reported daily over the same period.
Results
With demographics and health controlled, AAs displayed poorer sleep efficiency, greater
time awake after sleep onset and sleep fragmentation, and marginally more awakenings
during the night, but no differences in total sleep time. AAs also showed greater
night-to-night variability in number of awakenings and sleep fragmentation, and marginally
greater variability in total sleep time and sleep efficiency. Sleep quality was not
associated with pain either the day before sleep or the day after. Average daily pain
interacted with race, whereas AAs displayed no effect of pain on sleep efficiency,
NHWs exhibited better sleep efficiency at higher levels of average pain.
Conclusions
These data corroborate previous studies documenting poorer sleep among AAs vs NHWs.
The findings of greater night-to-night variability in sleep among AAs, as well as
a negative association of pain with sleep quality among NHWs, are unique. Further
study is needed to elucidate these findings.
Keywords
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Article info
Publication history
Published online: April 22, 2017
Accepted:
March 22,
2017
Received in revised form:
March 21,
2017
Received:
February 1,
2017
Identification
Copyright
© 2017 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.
