0435 Patient-provider Conversations About Sleep At The Us-mexico Border: Roles Of Acculturation And Insomnia. (27th April 2018)

• Record Type: Journal Article
• Authors: Madhavaram, S
• Is Part Of: Sleep. Volume 41(2018)Supplement 1
• Page Start: A165
• Page End: A165
• Publication Date: 2018-04-27
• Subjects: Sleep -- Physiological aspects -- Periodicals; Sleep disorders -- Periodicals; Sommeil -- Aspect physiologique -- Périodiques; Sommeil, Troubles du -- Périodiques; Sleep disorders; Sleep -- Physiological aspects; Sleep -- physiological aspects; Sleep Wake Disorders; Psychophysiology; Electronic journals; Periodicals; 616.8498
• DOI: 10.1093/sleep/zsy061.434
• Languages: English
• ISSNs: 0161-8105

Abstract

Abstract: Introduction: Sleep issues are under-addressed in medical visits, especially in underserved populations. The present study examined factors related to patient-provider sleep conversations among individuals of Mexican descent at the US-Mexico border, focusing on the role of sleep symptoms and acculturation. Acculturation refers to changes that take place because of contact with culturally dissimilar people, groups and social influences and can play an important role in psychosocial and health outcomes for individuals that live in geographical locations different from where they were born. Methods: Self-report data from N=100 individuals of Mexican descent were collected at the US-Mexico border in Nogales, Arizona. Participants were asked whether they discussed sleep health with their healthcare provider. Acculturation (Mexican and Anglo) were assessed using the Acculturation Rating Scale for Mexican-Americans. Insomnia symptoms were assessed with the Insomnia Severity Index in English or Spanish. Other variables included demographics, socioeconomics, depressed mood, and sleep medication use. Logistic regression was used to examine the odds of a sleep health discussion with health care provider as a function of acculturation and insomnia severity, adjusting for sex, poverty, smoking, depressed mood, and sleep medication use. Results: Only 15% of patients reported having sleep conversations about sleep with their provider. In a model that included only covariates, none of the control variables were significantly predictive of patient-provider interactions. After controlling for covariates, increased likelihood of patient-provider conversations was predicted by increased Insomnia Severity Index scores (Each additional ISI point was associated with OR=1.2, p=0.03) and Anglo acculturation (OR=2.3, p=0.04), but not Mexican acculturation (p=0.67). Conclusion: Few individuals of Mexican descent at the US-Mexico border report patient-provider discussions about sleep health. This was unrelated to demographics, socioeconomics, or sleep medication use. Whether the participants had discussed sleep health with their provider was predicted by increased insomnia symptom severity and Anglo (but not Mexican) acculturation. Thus, those with worse sleep symptoms and greater Anglo acculturation were more likely to report these conversations. Support (If Any): Supported by NIH/NHLBI K23HL125939 and K07AG052685.