Self-reported sleep characteristics and mortality in older adults of Mexican origin: Results from the hispanic established population for the epidemiologic study of the elderly

Objectives To determine how poor sleep affects the health of older ethnic minorities. Design Cross-sectional study involving a population-based survey. Setting Hispanic Established Population for the Epidemiologic Study of the Elderly (H-EPESE) survey conducted in the southwestern United States. Participants Two thousand two hundred fifty-six Mexican-American men and women aged 65 and older. Measurements The association between self-reported sleep problems and mortality over a 15-year period in a population based sample of older Mexican Americans was examined. Using five waves of data (1993-2008) from the H-EPESE, Cox proportional hazard models stratified according to sex were used to model the risk of death as a function of chronic sleep problems. Results Having any sleeping problems during the last month was associated with greater risk of mortality (hazard ratio = 1.14, 95% confidence interval = 1.00-1.29) in unadjusted models, although the association was attenuated after accounting for covariates. Conclusions Similar factors explained the association between sleep and mortality in men and women: health behaviors, depressive symptoms, and health conditions. These factors are related to stress, and both may lead to poor sleep quality. Research is needed to better understand the factors moderating the relationship between sleep, mortality, and sex.