Sleep, health, and race/ethnicity

From Billings, et al. 2021

Sleep is inextricably tied to our health. Getting enough sleep, the amount of uninterrupted sleep, how deeply we sleep.

Are our sleep patterns tied to race, gender, how we are treated, where we live, etc.–social as well as biological factors? What does the research say?

This is an update to The importance of sleep and its impacts (physical and mental health) bibliography; for the most current version of the bibliography, see —

Featured articles (these articles have been added to the Science Primary Literature database):

*Billings, M. E., Cohen, R. T., Baldwin, C. M., Johnson, D. A., Palen, B. N., Parthasarathy, S., . . . Sharma, S. (2021). Disparities in sleep health and potential intervention models: A focused review. Chest, 159(3), 1232-1240. [PDF] [Cited by]

Disparities in sleep health are important but underrecognized contributors to health disparities. Understanding the factors contributing to sleep heath disparities and developing effective interventions are critical to improving all aspects of heath. Sleep heath disparities are impacted by socioeconomic status, racism, discrimination, neighborhood segregation, geography, social patterns, and access to health care as well as by cultural beliefs, necessitating a cultural appropriateness component in any intervention devised for reducing sleep health disparities. Pediatric sleep disparities require innovative and urgent intervention to establish a foundation of lifelong healthy sleep. Tapping the vast potential of technology in improving sleep health access may be an underutilized tool to reduce sleep heath disparities. Identifying, implementing, replicating, and disseminating successful interventions to address sleep disparities have the potential to reduce overall disparities in health and quality of life.”

*Jackson, C. L., Powell-Wiley, T., Gaston, S. A., Andrews, M. R., Tamura, K., & Ramos, A. (2020). Racial/Ethnic disparities in sleep health and potential interventions among women in the United States. Journal of Women’s Health, 29(3), 435-442. [PDF] [Cited by]

“While essential for health and wellness, the various dimensions of sleep health are generally not equitably distributed across the population, and reasons for racial/ethnic sleep disparities are not fully understood. In this review, we describe racial/ethnic sleep disparities and subsequent implications for health from prior and recently conducted epidemiological and clinical studies as well as the potential sleep interventions presented at the 2018 Research Conference on Sleep and the Health of Women at the National Institutes of Health. Given the clear connection between sleep and poor health outcomes such as cardiovascular disease, we concluded that future studies are needed to focus on sleep health in general, sleep disorders such as insomnia and obstructive sleep apnea in particular, and disparities in both sleep health and sleep disorders among women using an intersectional framework. Future research should also integrate sleep into interventional research focused on women’s health as these results could address health disparities by informing, for example, future mobile health (mHealth) interventions prioritizing women beyond the clinical setting.”

*Johnson, D. A., Jackson, C. L., Williams, N. J., & Alcántara, C. (2019). Are sleep patterns influenced by race/ethnicity – a marker of relative advantage or disadvantage? Evidence to date. Nature and Science of Sleep, 11, 79-95. [PDF] [Cited by]

Sleep is a fundamental necessity of life. However, sleep health and sleep disorders are not equitably distributed across racial/ethnic groups. In fact, growing research consistently demonstrates that racial/ethnic minorities are more likely to experience, for instance, shorter sleep durations, less deep sleep, inconsistent sleep timing, and lower sleep continuity in comparison to Whites. However, racial/ethnic disparities in reports of sleepiness and sleep complaints are inconsistent. Racial/ethnic groups have significant heterogeneity, yet within-group analyses are limited. Among the few published within-group analyses, there are differences in sleep between non-US-born and US-born racial/ethnic groups, but the group with the more favorable sleep profile is consistent for non-US-born Latinos compared to US-born Latinos and Whites but unclear for other racial/ethnic minority groups. These sleep health disparities are a significant public health problem that should garner support for more observational, experimental, intervention, and policy/implementation research. In this review, we 1) summarize current evidence related to racial/ethnic disparities in sleep health and within-group differences, focusing on the sleep of the following racial/ethnic minority categories that are defined by the United States Office of Management and Budget as: American Indian/Alaska Native, Asian, African American/Black, Hispanic/Latino, and Native Hawaiian/Pacific Islander; 2) discuss measurement challenges related to investigating sleep health disparities; 3) discuss potential contributors to sleep health disparities; 4) present promising interventions to address sleep health disparities; and 5) discuss future research directions on intersectionality and sleep health.”

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