PROJECT SUMMARY
Asian Americans have more sleep deficiencies compared to Whites or Hispanics. However, most studies of
sleep disparities have focused on African Americans and Hispanics, and research on Asians remains scarce.
Our preliminary study among Chinese, Korean, and Vietnamese Americans found that acculturative stress was
inversely associated with sleep duration and positively associated with sleep disturbance and risk of sleep apnea.
Importantly, COVID-19 has adversely affected health, including sleep, with minority populations being
disproportionately affected. Additionally, increasing hate speech and racist attacks against Asians have been
reported, leading to increased mental and emotional toll in this population. Findings from the preliminary study
also demonstrated that sleep duration was inversely associated with diabetes, and sleep apnea was positively
associated with hypertension and obesity.
The overarching goal of this innovative longitudinal study is to understand: (1) mechanisms of sleep disparities
in relation to immigrant stressors and protective factors; and (2) consequences of sleep disparities on health
outcomes, in a sample of community-dwelling Chinese, Korean, and Vietnamese adults (n=750). This study
includes several innovations such as novel measures on anti-Asian racism due to COVID-19, the adverse impact
of COVID-19, and multi-dimensional sleep health; use of dried blood spots; purposive sampling of 3 Asian
subgroups; and considering ethnic enclaves as a protective factor.
Over the 5-year project period, the investigators will collect and analyze two waves of data in order to: (1)
Determine the longitudinal association between immigrant stressors (e.g., acculturative stress, psychological stress
and adverse impact of COVID-19, anti-Asian racism, and neighborhood disadvantage) and sleep health (a multi-
dimensional assessment of sleep health and disturbance); (2) Evaluate the moderating effect of potential
protective factors (e.g., social support, religious involvement, ethnic enclaves, and neighborhood social cohesion)
on the associations between immigrant stressors and sleep health; (3) Examine the longitudinal association
between sleep health and markers of cardiometabolic risk; and (4) Test whether specific dimensions of sleep
health will mediate the association between immigrant stressors and health outcomes.
This will be one of the first longitudinal studies to investigate mechanisms of sleep disparities in relation to
immigrant stressors and the consequences of sleep disparities on health outcomes among Asians, an
understudied minority population which displays poorer sleep outcomes relative to other groups. This study is
timely considering the rapid growth of Asians in the U.S., and the current hostile environment for Asians and
immigrants, including COVID-19. This innovative study will elucidate health issues of this understudied group and
identify modifiable factors that will serve as targets for intervention to reduce sleep disparities among Asians.
