Table 3.

Summary of evidence of positive or negative acculturation on various sleep health dimensions and disorders by measure of acculturation in a systematic review on acculturation and sleep health and sleep disorders in adult immigrant populations in the United States.

Acculturation Measurement	Sleep Duration/Timing	Sleep Quality/Continuity	Daytime Sleepiness	Sleep Disorders
Acculturation scales	MR [19,38,39,41–43,59]	MR [19,39,42–46,48,59,63,77]	MR [42,48,78]	MR [15,42,43,46–50]
Acculturative stress	MR [14,17,40,51,52]	↓ [17,40,52–54]	↓ [14]	↓ [14,40]
Proxy measures of acculturation	MR [12,18,20,28,55–59,79]	MR [18,57,59,60]	→ [25]	MR [15,18,25,61,62]

Note: The direction of the arrow refers to consistent evidence of positive or negative acculturation: ↑ indicates positive acculturation, or that U.S. acculturation is beneficial to the sleep outcome; ↓ indicates negative acculturation, or that U.S. acculturation is harmful to the sleep outcome; → indicates no association between U.S. acculturation and the sleep outcome; and “MR” indicates mixed results