Sleep disparities
Lack of sleep is associated with chronic conditions such as type 2 diabetes, heart disease, obesity and depression. It can lead to car crashes and mistakes at work, leading to injury and disability. And it’s been associated with early death.
The association between lack of sleep and heart disease has been compelling enough that in 2022 the American Heart Association added sleep to its heart health checklist, along with nicotine exposure, physical activity, diet, weight, blood glucose, cholesterol and blood pressure.
About one-third of U.S. adults reported not getting enough sleep in 2020, according to data from the U.S. Behavioral Risk Factor Surveillance System, a nationally representative telephone survey that collects state-level data about health-related risk behaviors and is run by the Centers for Disease Control and Prevention. That makes for about 35% of adults who sleep less than 7 hours per day, a trend that has remained relatively unchanged since 2013. The CDC recommends 7 or more hours of sleep for adults 18 years and older.
The amount of sleep U.S. adults get varies based on age, sex, state and county of residence, and race and ethnicity.
More 25- to 44-year-olds reported not sleeping enough, compared with other adults, the CDC data shows. Sleep patterns change with age and most of the change happens between young and middle-aged adults and tends remain mostly unchanged in older adults, research shows.
When looking at men and women, slightly more men than women reported lack of sleep in 2020, the CDC data shows. These differences can be driven by menstrual cycles, pregnancy, menopause, and sleep disorders such as insomnia and sleep apnea. For instance, studies show that sleep apnea is more common in men than women, due to factors such as obesity, upper airway anatomy, hormones and aging.
Meanwhile, women tend to report more sleep problems, including inadequate sleep time and insomnia.
Matsumura, who has researched sleep inequities in women, says there’s a psychological component to higher rates of insomnia in women, as they’re more likely to be affected by domestic violence, workplace discrimination, misogyny in workplace and in the world.
“And that weighs heavy on women’s emotional well-being, which then infiltrates into sleep,” she says.
There’s also a delay in diagnosing sleep disorders in women, because oftentimes they’re “explained away,” by health providers, she says.
“‘Oh, you have kids. Oh, you’re taking care of parents. Oh, well, your husband’s away at work all the time.’ The classic, stereotypical reasons to explain away women’s symptoms, when in fact, they may actually have a sleep disorder,” Matsumura says. “And there haven’t been enough studies and data to really identify these disparities and really help close the gap.”
Sleep deficiencies also vary by race and ethnicity, the CDC data shows: 31% of white and Asian adults and 32% of Hispanic or Latinos reported that they were not getting enough sleep in 2020, lower than the national average of 35%. In comparison, 38% of American Indian or Alaska Natives, 43% of Black people, and 47% of Native Hawaiian and other Pacific Islanders reported sleeping less than 7 hours per night.
