Nature and Science of Sleep (Jul 2019)
Are sleep patterns influenced by race/ethnicity – a marker of relative advantage or disadvantage? Evidence to date
Abstract
Dayna A Johnson,1,2 Chandra L Jackson,3,4 Natasha J Williams,5 Carmela Alcántara61Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; 2Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA; 3Department of Health and Human Services, Epidemiology Branch, National Institute on Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA; 4Department of Health and Human Services, Intramural Program, National Institute of Minority Health and Health Disparities, Bethesda, MD, USA; 5Department of Population Health, New York University School of Medicine, Center for Healthful Behavior Change, New York, NY, USA; 6School of Social Work, Columbia University, New York, NY, USAAbstract: 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.Keywords: sleep, disparities, race/ethnicity, minority, measurement
