0162 The Association Between Perceived Stress and Insomnia Among Asian Americans

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Abstract Introduction Studies have found that perceived stress is associated with sleep outcomes. However, there is a lack of data examining the association between perceived stress and insomnia among community-dwelling Asian Americans. We investigated the association between perceived stress and insomnia among 779 community-dwelling Asian Americans. Methods The cross-sectional study consisted of 256 Chinese-, 256 Korean- and 267 Vietnamese Americans ages 30 years or older residing in Southern California. We assessed perceived stress using a 4-item Perceived Stress Scale (PSS) (Range 0-16; Cronbach’s alpha = 0.62). A summed continuous total score was calculated. Insomnia was assessed by using the Insomnia Severity Index (ISI) and dichotomized as having moderate/severe insomnia (ISI score ≥ 15) vs. no/subthreshold insomnia. Logistic regression analysis examined associations between perceived stress and insomnia. Results Mean age of the study population was 55 years, and 44% identified as male sex. In total, 15% of the study population met the criteria for moderate/severe insomnia. One unit increase in the perceived stress scale was associated with 1.20 times higher odds of moderate/severe insomnia (95% Confidence Interval (CI): 1.10-1.30), adjusting for age and sex. When this association was further adjusted for the Asian subgroup, marital status, education, employment status, income, and type of health insurance, the association did not change substantively (OR=1.16, 95% CI:1.06-1,28). However, with further adjustment for depression (assessed by the Center for Epidemiologic Studies Depression Scale (CES-D)), the association was no longer significant (OR = 0.99; 95% CI: 0.88-1.10). This association did not differ by the Asian subgroup. Conclusion Higher levels of perceived stress were associated with higher odds of insomnia among Asian Americans after adjusting for sociodemographic variables. Adjustment of depression resulted in attenuation of the association. Whether depression mediates or confounds the association between perceived stress and insomnia should be examined in the prospective analysis. Support (if any) This study is funded by the National Institute of Minority Health and Health Disparities (R01MD015186; PI: Lee)

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