Abstract Body (Do not enter title and authors here): Introduction: Older African American women experience high levels of psychosocial stress, which are associated with poorer sleep quality. Both factors contribute to elevated cardiometabolic risk. Although perceived stress and sleep quality have been widely studied as correlates of cardiometabolic outcomes, little is known about their item-level interrelationships. To address this gap, we applied network analysis to explore how individual stress items and sleep quality subdomains cluster and connect. This approach may help identify specific stress symptoms that are strongly linked to components of sleep quality in this at-risk population, providing deeper insight than composite scores alone.
Research Questions: What is the network structure of perceived stress and sleep quality among older African American women?
Methods: Baseline data were analyzed from 117 older African American women (ages 50–75) enrolled in the Resilience, Stress, and Ethnicity (RiSE) study. Perceived stress was measured using the 10-item Perceived Stress Scale (PSS), and sleep quality was assessed using the seven subdomains from the Pittsburgh Sleep Quality Index (PSQI). Four PSS items (4, 5, 7, 8) were reverse scored. Regularized partial correlation networks were estimated using the EBICglasso algorithm in R. Centrality indices—strength (direct connection strength), closeness (proximity to all other nodes), and betweenness (frequency of acting as a bridge between nodes)—were computed to explain the network characteristics of the 17 items (10 PSS and 7 PSQI).
Results: Network analysis identified two dense clusters: one composed of all PSS items and the other of most PSQI subdomains, excluding the overall sleep quality subdomain. Among stress items, PSS8 (“felt not on top of things”) showed the highest strength, followed by PSS2 (“unable to control important things”). Among sleep subdomains, daytime dysfunction had the highest closeness and betweenness, serving as a key bridge between stress and sleep components.
Conclusions: PSS8 and PSS2 emerged as the most central stress items linked to sleep quality, highlighting perceived lack of control as a potential intervention target. These findings support the utility of network analysis in pinpointing core symptoms that bridge perceived stress and sleep quality. The results may inform more precise and culturally tailored strategies to reduce stress-related sleep disturbances among in African American women.