Daytime Sleepiness and Sleep Symptoms of Mexican-Americans and Mexicans: A Binational Comparative Study

Tuesday, July 12, 2011: 3:45 PM

Carol M. Baldwin, PhD, RN, AHN-BC, FAAN1
Darya McClain, PhD2
Manuela Vital, MSN, RN, ANP3
Angela Chia-Chen Chen, PhD, RN, PMHNP-BC2
Cipriana Caudillo-Cisneros, RN, MS4
Sergio Márquez-Gamiño, MD, PhD5
Luxana Reynaga-Ornelas, MN, RN4
Stuart F. Quan, MD6
(1)College of Nursing & Health Innovation; Southwest Borderlands; Director, Center for World Health Promotion & Disease Prevention, Arizona State University, Phoenix, AZ
(2)College of Nursing & Health Innovation, Arizona State University, Phoenix, AZ
(3)Center for the Advancement of EBP (CAEP), Arizona State University College of Nursing & Health Innovation, Phoenix, AZ
(4)Departamento de Enfermería y Obstetricia sede León, Universidad de Guanajuato Campus León, León, Guanajuato, Mexico
(5)Departamento de Ciencias Aplicadas al Trabajo. División de Ciencias de la Salud, Universidad de Guanajuato Campus León, León, Guanajuato, Mexico
(6)Division of Sleep Medicine, University of Arizona, Tucson and Harvard School of Medicine, Boston, Tucson, AZ

Learning Objective 1: Distinguish between health disparities and sleep disorders of Mexican Americans and Mexicans.

Learning Objective 2: Compare and contrast the prevalence of sleep symptoms and Epworth Sleepiness Scale scores between Mexican Americans and Mexicans.

Purpose: Daytime sleepiness often results from night-time sleep problems, including insomnia and sleep apnea. The Epworth Sleepiness Scale is the most commonly used subjective measure of daytime sleepiness in clinical and research settings. This bi-national study is a first step at examining Epworth scores and sleep disorders of Mexican Americans and Mexicans in order to developing culturally and regionally responsive sleep education and interventions.

Methods: Mexican Americans (N=204; 56% women) and Mexicans (N=202; 53% women) provided demographic and sleep data derived from the Spanish-translated NIH NHLBI Sleep Heart Health Study Sleep Habits Questionnaire (SHQ) that included the Epworth. Data were analyzed using frequencies, chi-squared tests and analysis of variance with PASWv18.

Results: Mexican Americans compared to Mexicans were older (40.5±13.5 versus 36.9±13.2 years, p<0.05), less likely to be insured (45.6% versus 80.7%, p<0.001), and more likely to earn over $5K/year (74% versus 98.5%, p<0.001). Both groups indicated approximately 10 years of education. Mexican Americans reported more insomnia symptoms (37.3% versus 27.8%, p<0.05), while Mexicans reported feeling unrested (30.7% versus 22.5%, p<0.01) and sleepier during the day (16.8% versus 10.7%, p<0.01) on the SHQ. Mean Epworth scores did not differ between groups; however, Mexican Americans were more likely to report ‘resting in the afternoon’ compared to Mexicans (51.9% versus 38.1%, p<0.01) with a trend for dozing while watching TV (42.1% to 31.2%, p<0.10). Mexican Americans also reported more drowsy driving (4.4% versus 1.5%, p<0.10).

Conclusion: Although they earn more than Mexicans, lack of insurance and education are significant access to care issues for Mexican Americans. Higher rates for insomnia symptoms (difficulty with sleep onset and maintenance) may contribute to Mexican Americans’ higher afternoon ‘siesta’ and drowsy driving rates. Findings underscore the need for ‘immigration health’ training for providers, and culturally relevant sleep education and interventions in nursing practice and research bi-nationally.