Objectives: Insomnia is reported to be more prevalent in minority racial/ethnic groups. Little is known, however, about racial/ethnic differences in changes in insomnia severity over time, particularly among older adults. We examined racial/ethnic differences in trajectories of insomnia severity among middle-aged and older adults. Design: Data were drawn from five waves of the Health and Retirement Study (2002-2010), a nationally representative longitudinal biennial survey of adults aged > 50 years. Setting: Population-based. Participants: 22,252 participants from non-Hispanic white, non-Hispanic black, Hispanic, and other racial/ethnic groups. Measurements: Participants reported the severity of four insomnia symptoms; summed scores ranged from 4 (no insomnia) to 12 (severe insomnia). We assessed change in insomnia across the five waves as a function of race/ethnicity. Results: Across all participants, insomnia severity scores increased 0.19 points (95% CI: 0.14-0.24; t = 7.52; design df = 56; p < 0.001) over time after adjustment for sex, race/ethnicity, education, and baseline age. After adjusting for the number of accumulated health conditions and body mass index, this trend decreased substantially and even changed direction (B = -0.24; 95% CI: -0.29 to -0.19; t = -9.22; design df = 56; p < 0.001). The increasing trajectory was significantly more pronounced in Hispanics compared with non-Hispanic whites, even after adjustment for number of accumulated health conditions, body mass index, and number of depressive symptoms. Conclusions: Although insomnia severity increases with age-largely due to the accumulation of health conditions-this trend appears more pronounced among Hispanic older adults than in non-Hispanic whites. Further research is needed to determine the reasons for a different insomnia trajectory among Hispanics.
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机译：目标：据报道失眠在少数种族/族裔人群中更为普遍。然而，关于失眠严重程度随时间变化的种族/种族差异知之甚少，尤其是在老年人中。我们研究了中老年人失眠严重程度的种族/种族差异。设计：数据来自《健康与退休研究》（2002-2010年）的五次浪潮，这是一项全国代表性的纵向双年度调查，涉及年龄大于50岁的成年人。地点：以人口为基础。参与者：来自非西班牙裔白人，非西班牙裔黑人，西班牙裔和其他种族/族裔群体的22,252名参与者。测量：参与者报告了四种失眠症状的严重程度;总分从4（无失眠）到12（严重失眠）不等。我们根据种族/种族评估了五次失眠的变化。结果：在对性别，种族/民族，教育程度和基线年龄进行调整之后，失眠严重程度得分随时间的推移增加了0.19分（95％CI：0.14-0.24; t = 7.52;设计df = 56; p <0.001）。 。在调整了累积的健康状况和体重指数后，这种趋势大大降低，甚至改变了方向（B = -0.24; 95％CI：-0.29至-0.19; t = -9.22;设计df = 56; p < 0.001）。即使对累积的健康状况，体重指数和抑郁症状的数量进行了调整，与非西班牙裔白人相比，西班牙裔的增长轨迹也更加明显。结论：尽管失眠的严重程度随着年龄的增长而增加，很大程度上是由于健康状况的累积所致，但这一趋势在西班牙裔老年人中比非西班牙裔白人更为明显。需要进一步的研究以确定西班牙裔人失眠轨迹不同的原因。
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