Racial/Ethnic Differences in Insomnia Trajectories among U.S. Older Adults

Christopher N. Kaufmann, Ramin Mojtabai, Rebecca S. Hock, Roland J Thorpe, Sarah L. Canham, Lian Yu Chen, Alexandra M V Wennberg, Lenis P. Chen-Edinboro, Adam P Spira

Research output: Contribution to journalArticle


Objectives Insomnia is reported to be more prevalent in minority racial/ethnic groups. Little is known, however, about racial/ethnic differences in changes in insomnia severity over time, particularly among older adults. We examined racial/ethnic differences in trajectories of insomnia severity among middle-aged and older adults. Design Data were drawn from five waves of the Health and Retirement Study (2002-2010), a nationally representative longitudinal biennial survey of adults aged > 50 years. Setting Population-based. Participants 22,252 participants from non-Hispanic white, non-Hispanic black, Hispanic, and other racial/ethnic groups. Measurements Participants reported the severity of four insomnia symptoms; summed scores ranged from 4 (no insomnia) to 12 (severe insomnia). We assessed change in insomnia across the five waves as a function of race/ethnicity. Results Across all participants, insomnia severity scores increased 0.19 points (95% CI: 0.14-0.24; t = 7.52; design df = 56; p <0.001) over time after adjustment for sex, race/ethnicity, education, and baseline age. After adjusting for the number of accumulated health conditions and body mass index, this trend decreased substantially and even changed direction (B = -0.24; 95% CI: -0.29 to -0.19; t = -9.22; design df = 56; p <0.001). The increasing trajectory was significantly more pronounced in Hispanics compared with non-Hispanic whites, even after adjustment for number of accumulated health conditions, body mass index, and number of depressive symptoms. Conclusions Although insomnia severity increases with age - largely due to the accumulation of health conditions - this trend appears more pronounced among Hispanic older adults than in non-Hispanic whites. Further research is needed to determine the reasons for a different insomnia trajectory among Hispanics.

Original languageEnglish (US)
Pages (from-to)575-584
Number of pages10
JournalAmerican Journal of Geriatric Psychiatry
Issue number7
StatePublished - Jul 1 2016



  • Aging
  • Chronic health conditions
  • Disparities
  • Insomnia

ASJC Scopus subject areas

  • Psychiatry and Mental health
  • Geriatrics and Gerontology

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