Asian and Hispanic Veterans Experience Insomnia More Than White Veterans, Study Finds

A new study found that Asian and Hispanic veterans experience greater rates of insomnia than other racial or ethnic groups.

A research team led by Sofia Rubi, BS, of the department of psychiatry at University of Missouri, wanted to investigate insomnia among veterans of different racial or ethnic groups. They also researched if PTSD and romantic partners could be associated with insomnia.

The study included 325 adult veterans, aged >18 years. There were 236 (73%) people of: 12% Asian, 36% Black, and 14% Hispanic/Latine.

The team used a descriptive statistic to find patterns across racial or ethnic groups while a linear regression was used to test the association between racial discrimination and insomnia severity.

The 7-item Insomnia Sleep Index (ISI) measured insomnia symptoms; participants had to fill out a survey, answering yes or no to sleep-related questions, with scores >10 indicating a positive screen for insomnia.

In all, 68% of the participants screened positive for insomnia—including 65% of Black participants and 58% ofWhite participants.

Asian participants had significantly higher rates of insomnia than White participants (χ2(1) =11.74, P <.001).

“Though we cannot be certain why rates of insomnia were highest among Asian veterans, Asian Americans are especially at risk for discrimination following the COVID-19 pandemic (Huang & Tsai, 2023), which may explain why they had the greatest rates of insomnia in this sample (data collected in early 2021),” the team wrote.

Racial discrimination could be characterized as a “chronic stressor” for Asian Americans or other minority groups. In a national survey, 61% of adults reported everyday discrimination due to their race or ethnicity. Stressful life events, such as being discriminated against, is known to “trigger or precipitate” the start of insomnia.

Even though Asians experienced the highest rate of insomnia of all racial or ethnic group, they also demonstrated the least interest in sleep treatment (also at 68%).

Meanwhile, White veterans had relatively low rates of insomnia (58%) but a relatively high interest in treatment (80%).

“Complementing our findings that veterans as a group are least willing to seek treatment for the conditions that are most prevalent in their communities, these data indicate that participants from racial/ethnic groups with the highest need for insomnia treatment are also among the least interested,” the investigators wrote. “Given these findings, providers are especially encouraged to screen for sleep problems and offer sleep treatment among veterans of color, as these minoritized groups may not share sleep issues spontaneously or request sleep treatment unprompted.”

The study found that racial discrimination and PTSD were both significantly associated with insomnia severity and was qualified by a significant interaction (B = 0.19, SE = 0.08), [95% CI, 0.34 - 0.04] (p = 0.01).

Romantic partners had been included in the study, but the team found they were not significantly linked to insomnia severity.

As for PTSD, everyone but 4 participants who screened positive for PTSD (95%) also screened positive for insomnia.

“As such, discrimination may not be linked to insomnia among veterans with PTSD because their sleep is already so disturbed,” the team wrote.

References

^{Rubi S, Monk JK, Shoemaker S, et al. Perpetuating and protective factors in insomnia across racial/ethnic groups of veterans [published online ahead of print, 2023 Oct 1]. J Sleep Res. 2023;e14063. doi:10.1111/jsr.14063}