The Role of Familism in the Relationship Between Ethnic Identity and Sleep in Hispanic/Latino Adults: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Hispanic/Latino individuals in the U.S. face sleep health disparities, reporting higher rates of short sleep duration and fragmented sleep compared to non-Hispanic white individuals. While Hispanic/Latino immigrants initially report better sleep health than their U.S.-born counterparts, prolonged residence in the U.S. is associated with worsening sleep, possibly due to acculturative stress. Ethnic identity and familism are cultural factors that have been correlated with positive health outcomes, even mitigating the adverse effects of acculturative stress and discrimination. However, little is known about the associations between these cultural factors and sleep health outcomes. This study aimed to examine the effect of ethnic identity on sleep in a sample of Hispanic/Latino adults and to examine whether familism moderates this relationship. Participants (n = 2159) completed questionnaires to assess demographic information, ethnic identity, and familism levels, and they wore wrist actigraphy to measure sleep outcomes. Regression analyses were performed using the Statistical Package for Social Sciences (SPSS) software to understand the relationship between ethnic identity and sleep and examine the potentially moderating role of familism in the relationship between ethnic identity and sleep health. Ethnic social affiliation was positively associated with sleep duration, while comfort with “mainstream” American culture was negatively associated with sleep efficiency and positively associated with sleep fragmentation index. Perceived discrimination was positively associated with sleep efficiency. Family support was positively associated with sleep efficiency, and degree of family influence in decision-making was positively associated with sleep fragmentation index. Familism moderated the relationship between ethnic social affiliation and sleep duration. Findings from this study have the potential to inform the development of culturally relevant sleep interventions.