American Journal of Epidemiology Advance Access originally published online on June 1, 2006
American Journal of Epidemiology 2006 164(1):5-16; doi:10.1093/aje/kwj199
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Original Contribution |
Objectively Measured Sleep Characteristics among Early-Middle-Aged Adults
The CARDIA Study
1 Department of Health Studies, University of Chicago, Chicago, IL
2 Section of Endocrinology, Department of Medicine, University of Chicago, Chicago, IL
3 Department of Preventive Medicine, Northwestern University, Chicago, IL
4 Department of Health Economics and Management, Guanghua School of Management, Peking University, Beijing, China
5 Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, CA
6 Division of Research, Kaiser Permanente Northern California, Oakland, CA
Correspondence to Dr. Diane S. Lauderdale, Department of Health Studies, University of Chicago, 5841 South Maryland Avenue MC 2007, Chicago, IL 60637 (e-mail: Lauderdale{at}uchicago.edu).
Despite mounting evidence that sleep duration is a risk factor across diverse health and functional domains, little is known about the distribution and determinants of sleep. In 2003–2004, the authors used wrist activity monitoring and sleep logs to measure time in bed, sleep latency (time required to fall asleep), sleep duration, and sleep efficiency (percentage of time in bed spent sleeping) over 3 days for 669 participants at one of the four sites of the Coronary Artery Risk Development in Young Adults (CARDIA) study (Chicago, Illinois). Participants were aged 38–50 years, 58% were women, and 44% were Black. For the entire sample, mean time in bed was 7.5 (standard deviation (SD), 1.2) hours, mean sleep latency was 21.9 (SD, 29.0) minutes, mean sleep duration was 6.1 (SD, 1.2) hours, and mean sleep efficiency was 80.9 (SD, 11.3)%. All four parameters varied by race-sex group. Average sleep duration was 6.7 hours for White women, 6.1 hours for White men, 5.9 hours for Black women, and 5.1 hours for Black men. Race-sex differences (p < 0.001) remained after adjustment for socioeconomic, employment, household, and lifestyle factors and for apnea risk. Income was independently associated with sleep latency and efficiency. Sleep duration and quality, which have consequences for health, are strongly associated with race, sex, and socioeconomic status.
educational status; ethnic groups; income; middle aged; sleep; socioeconomic factors
Abbreviations: CARDIA, Coronary Artery Risk Development in Young Adults
Editor's note: An invited commentary on this article appears on page 17, and the authors' response is published on page 19.
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