0733 Associations Between Multiple Dimensions of Sleep and Cognition by Race/Ethnicity and Gender

Abstract Introduction Sleep disturbances (including unhealthy duration, insomnia symptoms, and poor sleep quality) have been associated with impairments to memory and concentration. Although racially minoritized groups and women generally have poorer sleep quality and faster cognitive decline, few studies have investigated associations between multiple sleep dimensions and cognition by race/ethnicity and gender. Methods To investigate multiple sleep dimensions in relation to cognitive impairment, overall and by race/ethnicity and gender among US adults aged ≥40 years, cross-sectional data were pooled from the 2011-2018 National Health Interview Survey. Participants self-reported short ( 7 hours) and long (9 hours) sleep duration and sleep disturbances (i.e., insomnia symptoms: trouble falling asleep and/or staying asleep 3+ nights/week; non-restorative sleep: waking up not feeling rested 4+ nights/week). Cognitive impairment (yes vs. no) was self-reported in one item of the Washington Group Short Set on Functioning and defined as either not being able to or having a lot of difficulty remembering and concentrating. Using Poisson regression with robust variance and adjusting for sociodemographic, health behavior, and clinical characteristics, we estimated prevalence ratios for associations between sleep dimensions and cognitive impairment, overall and by race/ethnicity and gender. Results Among, 73,477 participants, mean age was 58.3±0.7 years, and most (86.7%) attained high school or higher education. Overall, 2.2% had cognitive impairment (by race/ethnicity: Latinx (2.5%), Asian (1.6%), Black/African American (2.5%), and White (2.1%); by gender: women (2.4%), men (1.9%)). Short sleep was associated with higher prevalence of cognitive impairment only among White adults (PR=1.30 95% CI:1.10-1.55 vs. range: PR-Asian=0.69 95% CI:0.33-1.45 to PR-Latinx=1.14 95% CI:0.75-1.73;p-interaction 0.05) Although long sleep duration was associated with a higher prevalence of cognitive impairment among the overall population (PR=4.10 95% CI:3.48-4.83), associations were strongest among Asian adults (PR=5.27 95% CI:2.84-9.80; p-interaction 0.05). Both insomnia symptoms (PR=1.40 [95% CI:1.40-1.87) and non-restorative sleep (PR=1.67 [95% CI:1.44-1.94) were associated with a higher prevalence of cognitive impairment across racial/ethnic groups. No associations varied by gender. Conclusion Short and long sleep, insomnia symptoms, and non-restorative sleep were associated with cognitive impairment with potential differences by race/ethnicity for sleep duration. Future studies identifying factors driving observed disparities by race/ethnicity and gender are warranted. Support (if any)