Sleep Disturbances and Sleep Apnea Associated with Complex Multimorbidity in Asian American Populations

Photo showing the head and shoulders of an older woman of Asian descent sleeping. She has 1 hand on her forehead, her brow is slightly furrowed

In this NIMHD study, focused on Chinese and Korean American populations experiencing sleep disturbances, researchers found an association between:

  • Complex multimorbidity
  • The coexistence of three or more chronic diseases in an individual
  • Sleep apnea risk

The study is the first known to examine the associations between sleep measures and complex multimorbidity and to analyze these relations among Asian Americans.

Researchers utilized data collected from 200 Chinese and 200 Korean American research participants in the Screening to Prevent Colorectal Cancer study from 2018 to 2020. The participants were ages 50 years to 75 years and lived in the Washington, D.C.-Baltimore metropolitan area. Complex multimorbidity was measured as the coexistence of three or more body system disorders assessed by self-report of physician-diagnosed diseases.

After determining the prevalence of chronic diseases and body systems affected in the entire sample and Asian subgroups (i.e., Chinese and Korean), the researchers examined the associations between complex multimorbidity and self-reported sleep disturbances (i.e., PROMIS measure, quality, depth, and restoration) and obstructive sleep apnea (OSA) risk. Finally, they analyzed the data to see how it changed by participants’ gender, Asian subgroup, and acculturation (i.e., number of years lived in the United States).

Having sleep disturbance was significantly associated with having complex multimorbidity among Chinese and Korean Americans. Data show that 18.2% of individuals in the sample had sleep disturbances, and individuals with sleep disturbances had 2.15 times the prevalence of complex multimorbidity compared to those who did not have sleep disturbances. Individuals at high risk of OSA had 1.19 times the prevalence of having complex multimorbidity.

A stronger association between sleep disturbances was found with male participants, Korean American individuals, and those who had lived in the United States for 22 years or less compared to their counterparts.

The researchers recommend public health strategies that educate providers and the public regarding signs/symptoms, risk factors, and treatments for sleep disorders and chronic diseases. They also promote further research to determine the effect of sleep health intervention for the prevention of chronic diseases in Asian American populations and other racial and ethnic minority groups.

Ryu, S., Morey, B.N., Lee, G.E., Kawachi, I., Redline, S., & Lee, S. (2023). The cross-sectional association of sleep disturbance and sleep apnea with complex multimorbidity among Chinese and Korean Americans. American Journal of Epidemiology, 192(3), 420-429.

Page published Feb. 20, 2024