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Volume 15 No. 06
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Accepted Papers

Scientific Investigations

Delayed Sleep Time in African Americans and Depression in a Community-Based Population

Omavi Bailey, MD, MPH1,2; Daniel Combs, MD1,2,3; Maria Sans-Fuentes, PhD1; Cody M. Havens, MPH1,4,5; Michael A. Grandner, PhD, MTR1,6; Chithra Poongkunran, MD1,2; Sarah Patel, MD1,2; Sarah Berryhill, BS1; Natalie Provencio, MS1; Stuart F. Quan, MD7,8; Sairam Parthasarathy, MD1,2,8
1UAHS Center for Sleep and Circadian Sciences, University of Arizona, Tucson, Arizona; 2Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, Department of Medicine, University of Arizona, Tucson, Arizona; 3Department of Pediatrics, University of Arizona, Tucson, Arizona; 4Department of Integrative Life Sciences, Virginia Commonwealth University, Richmond, Virginia; 5Virginia Institute of Psychiatric, Behavioral, and Statistical Genetics, Virginia Commonwealth University, Richmond, Virginia; 6Department of Psychiatry, University of Arizona, Tucson; 7Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; 8Asthma and Airways Disorders Research Center, University of Arizona, Tucson, Arizona

Study Objectives:

Studies have shown racial differences in circadian rhythm in African Americans when compared to non-Hispanic whites, and an association between circadian dyssynchrony and depression. We hypothesized that the prevalence of delayed sleep time is greater in African Americans when compared to whites and that delayed sleep time is associated with depression.


We analyzed data from the Sleep Heart Health Study (SHHS), a large community-based sample. Delayed sleep time was defined as self-reported weeknight bedtime after midnight. Depression was defined based on participant's response to the question, “In the past 4 weeks have you felt downhearted and blue?” or reported antidepressant use. We performed multivariate linear and logistic regression, adjusting for age, sex, race, body mass index, smoking, apnea-hypopnea index, alcohol use, and caffeine consumption.


Adjusted weekday bedtime was 15 ± 7 minutes later in African Americans compared to whites (P < .001). Similarly, weekend bedtime was 18 ± 7 minutes later in African Americans compared to whites (P = .025). The prevalence of delayed sleep time was greater in African Americans (33.3%) compared to whites (18.7%; P < .001). After adjusting for confounders, when compared to whites, a greater proportion of African Americans had delayed sleep time (adjusted odds ratio [aOR] 2.03; 95% confidence interval [95% CI] 1.5, 2.4; P < .0001). Depression was independently associated with delayed sleep time after adjustment (aOR 1.4; 95% CI 1.1, 1.7; P = .007).


African Americans are more likely to have a delayed sleep time compared to whites, and delayed sleep time was independently associated with depression.


Bailey O, Combs D, Sans-Fuentes M, Havens CM, Grandner MA, Poongkunran C, Patel S, Berryhill S, Provencio N, Quan SF, Parthasarathy S. Delayed sleep time in African Americans and depression in a community-based population. J Clin Sleep Med. 2019;15(6):857–864.

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