0315 The Social Drivers of Insomnia Among Asian Americans

Abstract Introduction Although Asian Americans are one of the fastest growing populations in the United States, and they experience insomnia and sleep disparities, no study to date has illuminated the social drivers/determinants of insomnia for this group. Methods We used cross-sectional survey data from 779 Asian Americans (256 Chinese, 256 Korean, and 267 Vietnamese) ages 30 years and older living in Southern California. The Insomnia Severity Index (ISI) categorized participants into those with no clinically significant insomnia (0-7), subthreshold insomnia (8-14), and moderate/severe insomnia (≥15). Participants provided data on the social drivers of health (SDOH), including: age, gender, Asian ethnicity, marital status, education, household income, employment status, shift work, nativity, age at immigration, years lived in the US, English fluency, level of acculturation, and self-rated health. Using multinomial logistic regression, we examined associations between each SDOH and insomnia category for the total sample. We then repeated this analysis separately for men and women. Results Moderate/severe insomnia was present for 14.8% of the total sample. Women had twice the odds of moderate/severe insomnia compared to men (OR: 2.05, 95% CI: 1.33, 3.16). In the total sample, age, Asian ethnicity, age at immigration, years in the US, and English fluency were not associated with insomnia, but being divorced/separated/widowed was associated with greater odds of moderate/severe insomnia compared to being married (OR: 2.46, 95% CI: 1.51, 4.01). Higher education level, full-time employment, higher income, and better self-rated health were all associated with lower odds of insomnia in the total sample. For women, those ≥60 years-old had over 2 times the odds of moderate/severe insomnia compared to those < 45 years-old (OR: 2.19, 95% CI: 1.08, 4.43). Never married men had 3 times the odds of moderate/severe insomnia as married men (OR: 3.04, 95% CI: 1.30, 7.14). Higher education was more strongly protective against insomnia for women than for men. Conclusion SDOH, including marital and socioeconomic status, are associated with insomnia among Chinese, Korean, and Vietnamese Americans, and these associations differ in interesting ways for women and men. Future interventions among Asian Americans should consider upstream SDOH for addressing insomnia. Support (if any)