Research Roundup
Sleep Health: An Opportunity for Public Health to Address Health Equity
Lauren Hale, Wendy Troxel and Daniel J. Buysse. Annual Review of Public Health, January 2020.
The study: This review study highlights the state of the science on the role of sleep in public health and describes the findings that link poor sleep health in adults with heart disease, obesity, mental health and neurodegenerative diseases, such as Alzheimer’s disease and Parkinson’s disease. The authors define sleep health and factors associated with it. They also discuss the potential role of sleep in understanding health disparities. The authors also discuss recommendations and opportunities for interventions and the importance of promoting sleep health to achieve health equity.
The findings: The authors present two arguments. First, sleep health is a critically important — and underrecognized — factor in overall health and specific health conditions. Second, social and environmental factors affecting sleep health are often beyond the control of an individual. They consider improving sleep health a necessary step toward achieving health equity.
The authors recommend making studying sleep health disparities in vulnerable population a top research priority. Some of understudied populations include prison inmates, people living in homeless shelters, American Indian and Alaska native populations and patients in hospitals and nursing homes.
The authors write: “As with other public health epidemics, such as obesity, that have increasingly recognized the limitations of individual-level interventions alone, sleep health and public health researchers will benefit from adopting a multilevel approach for developing and disseminating evidence-based and scalable interventions. Sleep health promotion efforts should be considered at all levels of the socioecological model from the individual level up through the societal level. Employers, teachers, community members, health care providers, the media, and policy makers all have a role to play in changing and promoting a culture of sleep health.”
Sleep Disparity, Race/Ethnicity, and Socioeconomic Position
Michael A. Grandner, et al. Sleep Medicine, February 2015.
The study: This review of existing literature summarizes research on sleep patterns across racial and ethnic groups, discusses how race and ethnicity may be associated with sleep, discusses the role of socioeconomic standing with sleep patterns and offers future research directions.
The findings: Among the studies that researchers highlight is one that finds people who perceived racial discrimination when seeking health care were almost twice as likely to report more sleep difficulties, compared with those who didn’t have the experience of discrimination. They were also 60% more likely to report daytime tiredness and fatigue. “This sleep disturbance associated with racism not only explains part of the relationship between racism and depression but may also account for racial differences in sleep architecture,” the authors write.
The authors write: “Because race is a social category rather than an innate genetic trait, researchers must more carefully unpack the function race can serve in identifying the reasons for these sleep disparities. We recommend a research agenda that examines the role of race, racism, and socioeconomic disadvantage in sleep and the role of sleep in health disparities.”
How Did Trends in Sleep Duration in 2020 Compare to Previous Years and How Did They Vary by Sex, Race/Ethnicity, and Educational Attainment?
Connor Sheehan, Longfeng Li and Megan E. Petrov. Sleep Medicine, January 2023.
The study: The authors set out to explore how sleep duration changed during the latter months of 2020, considering that people’s sleep patterns were considerably changed during the first months of the COVID-19 pandemic. Using the CDC’s Behavioral Risk Factor Surveillance System data for American adults, they compared the 2020 data with 2013, 2014, 2016 and 2018. The total sample was 2,203,861. The BRFSS is a population-based phone survey of American adults 18 years and older in 50 states, Washington D.C., Guam and Puerto Rico.
The findings: Sleep duration significantly increased during the first months of the pandemic, particularly during the lockdown in March and April, potentially due to having more time because of working from home, or job loss. “For many Americans, the lockdown represented the first real respite from the quotidian stressors of work,” the authors write. However, it reverted to historical patterns by the fall of 2020, and the sleep disparities and trends based on sex, race, ethnicity and education stayed the same as before the pandemic.
The authors write: “More research is needed to understand the short and long-term consequences of the short-lived increases in sleep duration. Regardless of the potential consequences, these brief increases did little to abate social inequality in sleep. Overall, our findings illustrate how ingrained sleep disparities are even in the face of an exogenous shock to population-level sleep duration patterns.”
