1050 A Nightmare at the US-Mexico Border: Prevalence Associated with Acculturation, Sleep Health, and Mental Health – Data from the NoCHeS Study

Abstract Introduction Previous research has linked nightmares to anxiety, depression, and poor sleep quality. However, much less is known about how nightmares intersect with acculturation patterns and bicultural experiences in border communities. Understanding the connection between nightmares and acculturation is especially important in contexts where cultural identity, discrimination, and cross-border living conditions may shape both psychological distress and sleep health Methods Data were collected from 992 working-age adults (age 25-60) living at the US-Mexico Border. Nightmares were assessed using the item, “How often have you had trouble sleeping because you had bad dreams?” Other variables included Mexican and Anglo acculturation as assessed by the Acculturation Rating Scale for Mexican Americans-II, Americanism, Hispanicism, and Biculturism as assessed by the Bicultural Involvement Questionnaire, degree of perceived control over sleep (Brief Index of Sleep Control), insomnia (Insomnia Severity Index), poor sleep quality (Pittsburgh Sleep Quality Index), snoring frequency, habitual sleep duration (self-reported and actigraphic minutes/night), PHQ9 depression score, and GAD7 anxiety score. All analyses were adjusted for age and sex. Results Adjusted models showed nightmares sometimes (vs never) were associated with lower Americanism (B=-3.22, 95%CI: -5.96, -0.47), lower Anglo acculturation (B=-0.20, 95%CI: -0.35, -0.04), higher Mexican acculturation (B=0.11, 95%CI: 0.01, 0.20), less sleep control (B=-0.34, 95%CI: -0.52, -0.17), worse insomnia (B=1.98, 95%CI: 1.37, 2.59) and sleep quality (B=0.62, 95%CI: 0.15, 1.10), more snoring (oOR=1.54, 95%CI: 1.14, 2.10), and more depression (B=1.25, 95%CI: 0.68, 1.83) and anxiety (B=0.98, 95%CI: 0.51, 1.46). Nightmares often (vs never) were associated with lower Americanism (B=-6.46, 95%CI: -10.41, -2.50), higher Biculturism (B=5.76, 95%CI: 0.75, 10.76), lower Anglo acculturation (B=-0.28, 95%CI: -0.50, -0.06), less sleep control (B=-0.66, 95%CI: -0.91, -0.41), worse insomnia (B=4.86, 95%CI: 3.98, 5.74) and worse sleep quality (B=1.44, 95%CI: 0.76, 2.12), less self-reported sleep duration (B=-35.17, 95%CI: -62.36, -7.97), more snoring (oOR=2.49, 95%CI: 1.58, 3.93) and more depression (B=4.52, 95%CI: 3.69, 5.35) and anxiety (B=3.54, 95%CI: 2.86, 4.21). Conclusion These findings emphasize the need to consider cultural context in both the assessment and treatment of sleep disturbances and suggest that nightmares may serve as a critical index of acculturative stress and mental health risk among US-Mexico border residents. Support (if any) R01MD011600, R01MH135978