Immigration as a social determinant of troubled sleep in Canada: some evidence from the Canadian Community Health Survey– Mental Health Yujiro Sano, PhD a, ⁎, Roger Antabe, MA b , Emmanuel Kyeremeh, MA b , Eugena Kwon, MA a , Jonathan Amoyaw, PhD c a Department of Sociology, University of Western Ontario, London, Ontario, Canada b Department of Geography, University of Western Ontario, London, Ontario, Canada c Department of Sociology, Dalhousie University, Halifax, Nova Scotia, Canada abstract article info Article history: Received 15 March 2018 Received in revised form 8 November 2018 Accepted 16 November 2018 Available online xxxx Keywords: Troubled sleep Healthy immigrant effect Social determinants of sleep Canadian Community Health Survey–Mental Health Background: The literature pays very little attention to immigrants' sleep in Canada, although sleep is essen- tial to individual health and well-being. Analysis: Drawing data from the Canadian Community Health Survey–Mental Health, we aim to address this void by comparing troubled sleep among recent immigrants, established immigrants, and the native- born Canadians. Results: Despite immigrants' declining health over time in Canada, our findings reveal that both recent and established immigrants report fewer cases of troubled sleep than their native-born counterparts. Recent (odds ratio [OR] = 0.70, 95% confidence intervals [CIs] = 0.62-0.79) and established immigrants (OR = 0.86, 95% CIs = 0.79-0.92) were less likely to report troubled sleep than the native-born at the bivariate level, although its significant impact for recent immigrants was completely attenuated when health status was controlled for (OR = 0.88, 95% CIs = 0.76-1.02). Established immigrants were still less likely to report fewer cases of troubled sleep than the native-born even after controlling for all control variables (OR = 0.88, 95% CIs = 0.81-0.96). Conclusion: Based on these findings, we discuss that fewer troubled sleep cases reported by immigrants may be explained by their initial health advantage, resilience trajectory, and cultural interpretation of sleep. We also provide several suggestions for future research. © 2018 National Sleep Foundation. Published by Elsevier Inc. All rights reserved. Introduction Sleep is essential to individual health and well-being. Research shows that adverse physical and mental health outcomes such as cor- onary heart disease, diabetes, hypertension, depression, and anxiety can be caused by insufficient sleep. 1 Similarly, insufficient sleep is also associated with vehicular accidents, industrial disasters, work- place hazards, and other occupational accidents. 2 Sleep disturbance is also linked to poor daytime functioning due to sleepiness, fatigue, anxiety, and depressed mood. 3 Clinical studies also emphasize the health benefits of quality sleep including daytime cognition, improved memory consolidation, and enhanced metabolism. 4,5 Among people with chronic depression and other health conditions, quality sleep is prescribed as useful in mitigating such conditions. 6 In this context, insufficient sleep may be a major barrier for immi- grants to achieve positive health, especially as the literature docu- ments that the health of immigrants often declines over time after their arrival in the host society. 7,8 Despite this concern, very little is known about immigrants' sleep especially among adult immigrants in Canada. There are several studies that explore the relationship be- tween sleep and immigrant status in the United States. For example, Seicean et al 1 find that Mexican-born immigrants have more favor- able sleep patterns than the American-born whites, potentially ac- counting for their low risk of diabetes, hypertension, and other chronic diseases. Hale et al 9 also discuss a similar pattern among Chi- nese and Japanese female immigrants and their native-born counter- parts in California and New Jersey. Sleep Health xxx (xxxx) xxx ⁎ Corresponding author. E-mail address: ysano@uwo.ca (Y. Sano). SLEH-00344; No of Pages 6 https://doi.org/10.1016/j.sleh.2018.11.008 2352-7218/© 2018 National Sleep Foundation. Published by Elsevier Inc. All rights reserved. Contents lists available at ScienceDirect Sleep Health Journal of the National Sleep Foundation journal homepage: sleephealthjournal.org Please cite this article as: Y. Sano, R. Antabe, E. Kyeremeh, et al., Immigration as a social determinant of troubled sleep in Canada: some evidence from the Canadian..., Sleep Health: Journal of the National Sleep Foundation, https://doi.org/10.1016/j.sleh.2018.11.008