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Sleep. 2011 Aug 1;34(8):1021-31. doi: 10.5665/SLEEP.1154.

An exploration of differences in sleep characteristics between Mexico-born US immigrants and other Americans to address the Hispanic Paradox.

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  • 1Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.



Decreased sleep duration and quality are associated with poor health. Given that Mexico-born US immigrants (MI) often have favorable health status relative to the general US population (USALL), we tested the hypothesis that MI have better sleep as compared to USALL and to Mexican-Americans (MA) born in the US.


Cross-sectional analysis of a stratified multistage probability sample of 18 years and older civilian non-institutionalized USALL enrolled in NHANES during 2005-2006. Age-adjusted population prevalence rates and adjusted odd ratios of short habitual sleep time (SHST) and insomnia were calculated using weighted analyses.


Computer assisted personal bilingual (English/Spanish) interviews in the participants' home using a sleep questionnaire.


5160 USALL participants, including 1046 MA, of whom 620 were MI.


In logistic regression models unadjusted and adjusted for socioeconomic characteristics, health related behavior risk factors, health status, and depression, MI status was significantly associated with lower odds of SHST (OR = 0.7, 95%CI [0.6-0.9]), insomnia (OR = 0.3, 95%CI [0.2-0.5]), and sleep-associated functional impairments (OR = 0.4, 95%CI [0.2-0.8]). In MA males, MI status was associated with reduced odds of SHST < 7 h/weeknight and insomnia symptoms. Cultural changes measured by increased levels of English compared to Spanish language spoken at home were associated with an increased risk of poor sleep in MA men in univariate models, and may partially explain better sleep in MI men compared to their US-born counterparts.


Compared to the general US poplulation, Mexican-born US immigrants have more favorable sleep, possibly contributing to their lower reported risk of diabetes, hypertension, CVD, and all-cause mortality (the "Hispanic Paradox").


Centers for Disease Control and Prevention (CDC); Mexican-American; Mexico-born; National Health and Nutrition Examination Survey (NHANES); US-born; cultural changes; immigrant; insomnia; sleep duration

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