CITATION
Cintron WR. When we sleep, where we sleep, and with whom we sleep are all important markers or indicators of social status, privilege, and health. J Clin Sleep Med. 2020;16(2):163.
In this issue of the Journal of Clinical Sleep Medicine, Seegan et al examined the association between internalizing symptoms (ie, anxiety, depressive, and somatic symptoms) and objectively measured sleep outcomes in a sample of Latino, African-Americans and non-Latino white urban children with and without asthma1 to show how asthma status moderated these associations.
An Institutional Review Board approved study, it has multiple strengths. The diagnosis of asthma is established following NIH-NHLBI latest guidelines for the diagnosis and treatment of asthma.2 Information in this respect is gathered from participant interviews, utilization of which medications and for how long is confirmed by the study clinicians. As part of the study, participant evaluations were done at their homes and the clinics. Follow-up was done for 4 years.
Cultural sensitivity is part of the study, as outlined that “22% of families preferred to complete the protocol in Spanish… Study instruments were presented in English or Spanish by fully bilingual research staff and according to each participant’s preference.” This is of paramount importance as there is a call in the scientific community to include more diversity in clinically oriented as well as genetic studies. Racial and ethnic minorities should be recruited for similar studies to avoid a biased picture and to ultimately benefit more people.3,4
The data were cleaned very stringently, undergoing a sophisticated analysis yielding the conclusions outlined. This study should be thought of as the base trial on which to build further initiatives. More individuals, with assessment of sleep outcomes not only in fall and winter, but through the whole year should be recruited in future, similar initiatives where replication of findings should be sought as the authors outline. It should be considered that Hispanic populations differ in their genetic ancestry4,5 and hence in their response to steroids at airway6 and sleep architecture7 level. This could be part of the “unexpected” direction of the association between depressive symptoms and shorter sleep onset latency in Latino children. Notwithstanding, the multidimensional nature of the relationship between anxiety of sleep deserves a different research approach.8
Overall, the study is a very good point of departure in the future in order to furtherly recommend sleep interventions tailored to urban and minority children with and without asthma. As outlined in the title of this commentary, in all of us, sleep affects our health in different ways.
DISCLOSURE STATEMENT
The author reports no conflicts of interest.
REFERENCES
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