Key result
Childhood US arrival is linked to ~154% higher odds of poor sleep among African immigrants.
Why the study?
Because cardiometabolic health declines in African immigrants after arrival in the United States, factors affecting sleep quality needed elucidation.
Does arriving in the US as a child compared to as an adult increase the risk of poor sleep quality in African immigrants?
Cross-Sectional (n=330)
Does arriving in the US as a child compared to as an adult increase the risk of poor sleep quality in African immigrants?
Odds Ratio: 2.54 (95% CI 1.33–4.85)
Absolute Event Rate: 52% vs 37%
p-value: p=<0.01
African immigrants who arrived in the US as children have significantly worse sleep quality in adulthood compared to those who arrived as adults, which may impact their cardiometabolic health.
Does not support practice changes in sleep assessment; hypothesis-generating for age-at-immigration effects on cardiometabolic risk.
Introduction and Objective: Poor sleep quality adversely affects cardiometabolic health. As cardiometabolic health declines in 330 African immigrants after arrival in the United States, factors affecting sleep quality in immigrants need elucidation. We determined in African immigrants how age, age at immigration, stress and income affect sleep quality. Methods: All 330 participants were enrolled in the Africans in America study and ≥20y old at study entry (Male: 57%; age: 39±11 (mean±SD), range 20 - 70y, BMI: 28.0±4.7, range 19.3 to 46.2 kg/m2). Age at immigration was defined as arriving in the US <18y (Child-Arrival) vs ≥18y (Adult-Arrival). Pittsburgh Sleep Quality Index (PSQI) and Cohen’s Perceived Stress Scale (PSS) were used to assess sleep and stress, resp. Poor sleep quality was defined as PSQI >5. The 7 components of the PSQI were evaluated separately. Low income was defined as <45k/year. Odds of PSQI>5 was determined with logistic regression with age, age at immigration, PSS and income as independent variables. Results: Child-Arrivals were 18% (58/330) of the cohort and Adult-Arrivals were 82% (272/330). PSQI was higher in Child-Arrival than Adult-Arrival (6.0±3.5 vs 4.9± 2.9, P=0.01). PSQI>5 was also more frequent in Child-Arrival (52% vs 37%, P=0.03). Subjective sleep quality, sleep disturbance and daytime dysfunction were worse in Child-Arrivals than Adult-Arrivals (all P<0.05). However, sleep duration, PSS and income did not differ (all P>0.7). The odds of PSQI>5 were higher for Child-Arrivals (OR 2.54, 95% CI: 1.33, 4.85, P<0.01), Age>40y (OR 1.74, 95% CI: 1.05, 2.89, P=0.03) and PSS (OR1.11, 95% CI: 0.07, 1.16, P<0.01); but not by income <45k (OR 1.25, 95% CI: 0.77, 2.03, P=0.37). Conclusion: Sleep quality is worse in African immigrants who arrived in the US as children compared to immigrants who arrived as adults. Sleep duration, standard measures of stress and income do not explain the difference. To improve cardiometabolic health in African immigrants more in depth study of poor sleep quality is necessary. Disclosure A. Bharadwaj: None. A. Shah: None. G. Smith: None. B. Izere: None. C. DuBose: None. M. Horlyck-Romanovsky: None. A. Sumner: None.
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BHARADWAJ et al. (2026) conducted a cross-sectional in Poor sleep quality (n=330). Arrival in the US as a child (<18 years) vs. Arrival in the US as an adult (≥18 years) was evaluated on Poor sleep quality (PSQI > 5) (OR 2.54, 95% CI 1.33-4.85, p=<0.01). African immigrants arriving in the US as children had significantly higher odds of poor sleep quality in adulthood compared to those arriving as adults (52% vs 37%; OR 2.54, 95% CI 1.33-4.85, P<0.01).
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