UC San Diego

Hispanic/Latino adults in the U.S. experience unique sociocultural contexts that shape their cardiometabolic health. Sleep and physical activity relate to cardiometabolic health and may play a role in health inequities among Hispanic/Latino adults. This 3-paper dissertation aimed to elucidate associations of sleep, physical activity, and cardiometabolic health by examining: (1) neighborhood environmental influences on multidimensional sleep health; (2) associations of average sleep and sleep variability with physical activity; and (3) how daily physical activity and sleep relate to blood glucose in pregnant individuals with diabetes.

Study 1 used data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL; 2008-2011) to investigate how neighborhood macro-environmental features (e.g., walkability, socioeconomic deprivation) related to multidimensional sleep health in 342 Hispanic/Latino adults in San Diego. Multivariable regression models adjusted for stratification and clustering found few statistically significant associations. Greater levels of air pollution were associated with later sleep midpoint, while greater social disorder was associated with earlier sleep midpoint. Lower walkability was associated with more wake after sleep onset (i.e., lower sleep quality). Study 2 used cross-sectional data from the HCHS/SOL (N=2156 participants from multiple Hispanic/Latino heritage groups living in 4 urban U.S. regions). Analyses accounted for complex survey design (stratification, clustering, sampling weights). Contrary to hypotheses, lower objectively measured sleep duration and greater variability in sleep midpoint were associated with greater physical activity. Study 3 used multilevel modeling to examine associations of daily physical activity (i.e., steps, moderate-to-vigorous physical activity) and sleep duration with postprandial and next day fasting blood glucose in 17 pregnant women with diabetes enrolled in a 12-week pilot physical activity intervention. Between- and within-person effects were tested. While this secondary analysis of pilot data was underpowered to detect statistical significance, the directions of associations were in line with previous research linking greater steps and sleep duration with lower postprandial and next day fasting blood glucose, respectively.

Findings elucidate relationships between behaviors and cardiometabolic health in Hispanic/Latino adults but raise questions regarding the relative health benefits of different sleep health dimensions and types/settings of physical activity. Future research may clarify whether sleep promotion interventions relate to improved glycemic management.