Associations of self-reported sleep duration and sleep difficulties with cardiometabolic risk factors among U.S.-born and foreign-born black adults in the United States: NHANES 2005-2016

Self-reported sleep duration and poor sleep quality are understudied determinants of cardiometabolic (CMB) health among Black populations. We conducted a cross-sectional analysis among 4,974 U.S.-born and 615 Foreign-born Black adults using a U.S. sample (2005-2016). Poisson regression models with robust variance were fit to estimate adjusted associations between self-reported sleep duration and difficulties with CMB risk factors (overweight, obesity, hypertension, diabetes). Effect modification by nativity and length of U.S. residence (Foreign-born) was assessed. Short sleep duration was associated with overweight (PR: 1.09, 95% CI: 1.03, 1.16) and obesity (PR: 1.06, 95% CI: 1.01, 1.10). Among U.S.-born adults, sleep difficulties were associated with a higher prevalence of hypertension (PR: 1.07, 95% CI: 1.01, 1.14). Among Foreign-born adults, longer sleep duration was associated with a lower prevalence of hypertension (PR: 0.94, 95% CI: 0.89, 0.99); and short sleep duration was associated with a higher prevalence of obesity (PR: 1.30, 95% CI: 1.04, 1.63). Among immigrants with <10 years in the U.S., short sleep duration was associated with hypertension (PR: 1.75, 95% CI: 1.13, 2.72). Overall, short sleep duration was associated with adverse CMB health. Associations between sleep and CMB health varied by nativity. As a heterogenous group, examining within-race associations help to more accurately assess risk and target CMB interventions.