Identifying Combinations of Factors Associated With Meeting Age-Specific Sleep Duration Recommendations Among US Midlife and Older Adults: A Study Using Signal Detection Analysis

Abstract

Objective

To identify subgroups of midlife and older adults from the United States (US), defined by specific combinations of factors, who are more or less likely to meet age-specific sleep duration recommendations.

Methods

Participants (n = 3,124) aged ≥ 40 years were drawn from the 2011-2018 National Health and Nutrition Examination Survey cycles. The primary outcome was meeting age-specific sleep duration recommendations (7 to 9 hours per night) to promote optimal health. Signal detection analysis was used to identify subgroups, defined by combinations of socio-demographic, clinical, cardiometabolic, and behavioral factors, that predicted whether participants met age-specific sleep duration recommendations.

Results

The mean age of participants was 58.3 (standard error = 0.3) years, with a mean sleep duration of 7.3 (standard error = 0.03) hours/night. Overall, 64.3% met the age-specific sleep duration recommendations. Eight subgroups were identified through signal detection, with race/ethnicity being the primary splitting variable. The subgroup most likely to meet the sleep duration recommendations (82.9%; 353/426) identified as Non-Hispanic White, had a poverty income ratio score ≥ 3.2 (indicating household income 3.2 times the poverty threshold), and had no history of trouble sleeping. In contrast, the subgroup least likely to meet the sleep duration recommendations (45.0%; 144/320) identified as racial/ethnic minorities, had a history of trouble sleeping, and engaged in less than 324 minutes of moderate-to-vigorous physical activity per week.

Conclusions

Findings from this cross-sectional study highlight the importance of examining combinations of factors to systematically identify subgroups more or less likely to meet age-specific sleep duration recommendations for optimal health. Future research should explore how these factors change over time to inform public health strategies aimed at improving sleep health among US midlife and older adults, particularly those from racial and ethnic minority backgrounds.