Acculturation and sleep outcomes in Asian Americans and Pacific Islanders: Results from the National Epidemiologic Survey on Alcohol and Related Conditions-III.

ABSTRACT Objectives This study investigates an association between acculturation and sleep outcomes in Asian Americans and Pacific Islanders, an understudied population in sleep studies. Design Cross-sectional. Participants About 1401 adults who spoke an Asian or Pacific Islander language from the National Epidemiologic Survey on Alcohol and Related Conditions-III. Measurements Acculturation was assessed using the Bidimensional Acculturation Scale and participants were categorized into non-Asian (proficient only in English), Bicultural (proficient in English and an Asian language), and Asian (proficient only in an Asian language). Nativity and years lived in the United States (US-born, ≤5 years, 6-20 years, and ≥21 years) was used as a proxy of acculturation. Linear and logistic regression models were examined associations between acculturation and sleep duration and sleep difficulties. Results Those in the Bicultural group slept slightly longer by 0.19 hours per day than those in the non-Asian group, but this increase was driven by those sleeping >9 hours. Foreign-born Asians who lived in the United States for 6-20 years and ≥21 years slept less by 0.17 and by 0.28 hours relative to US-born Asians. Foreign-born Asians who lived in the United States ≤5 years were less likely to have sleep difficulties than US-born Asians (odds ratio: 0.49, 95% confidence interval: 0.26-0.92). Conclusions The Bicultural group has unusually long sleep hours, while the benefits of not having sleep difficulties among recent immigrants did not exist among immigrants who lived a longer time in the United States. Future studies should identify the mechanism underlying the observed associations.