Study Highlights Racial Disparities in Optimal Sleep Duration

Black individuals are more likely than White and Hispanic individuals to sleep for shorter or longer than the recommended duration, according to a study published in JAMA Network Open. The study aimed to illuminate trends in racial and ethnic disparities in sleep duration.

The annual National Health Interview Survey (NHIS) provided data from 2004 to 2018; the Sample Adult Core file was also used. Individuals 18 years or older in the study period were included; respondents with missing sleep data and those who identified as non-Hispanic Alaskan Native or American Indian were excluded due to the small numbers of these respondents.

All participants were classified into 4 racial and ethnic subgroups: Asian, Black, Hispanic or Latino, and White based on survey responses. Self-reported age, sex, household income level, health status, and geographic region were also included.

Participants were asked to self-report sleep duration. Recommended sleep duration was identified as 7 to 9 hours of sleep in a 24-hour period, short duration defined as fewer than 7 hours, and long duration as more than 9 hours.

The study sample consisted of 429,195 individuals with a median (IQR) age of 46 (31-60) years; 51.7% were women. Patients identified as Asian (5.1%), Black (11.8%), Hispanic or Latino (14.7%), and White (68.5%).

Prevalence of short sleep was 31.4% (95% CI, 28.1%-34.8%) in Asian individuals, 35.3% (95% CI, 33.4%-37.2%) in Black individuals, 27.0% (95% CI, 25.4%-28.6%) in Hispanic individuals, and 27.8% (95% CI, 27.1%-28.6%) in White individuals in 2004. The prevalence of short sleep increased significantly in Black (6.39; 95% CI, 3.32-9.46 percentage points), Hispanic (6.61; 95% CI, 4.03-9.20 percentage points), and White (3.22; 95% CI, 2.06-4.38) individuals from 2004 to 2018.

By 2018, short sleep duration among Black and Hispanic individuals was higher by 10.68 percentage points (95% CI, 8.12-13.24) and 2.44 percentage points (95% CI, 8.12-13.24), respectively, compared with the estimated prevalence in White individuals (31.0%; 95% CI, 30.1%-31.9%). The difference between Black and White women during the study period was 12.07 percentage points, a difference of 9.14 percentage points was observed in Black and White men, and the difference between Hispanic and White men increased from 2004 to reach 3.68 percentage points in 2018.

Estimated prevalence of long sleep was 6.4% (95% CI, 5.4%-7.5%) in Black individuals, 4.6% (95% CI, 3.9%-5.3%) in Hispanic individuals, and 3.5% (95% CI, 3.2%-3.8%) in White individuals. Prevalence of long sleep duration in Black individuals was higher by 1.44 (95% CI, 0.39-2.48) percentage points compared with White individuals. Black women had higher prevalence of long sleep during the study period (1.83; 95% CI, 0.45-3.20 percentage points) compared with White women.

Short sleep duration was more prevalent in Black individuals when compared with White individuals of the same age, with a difference starting at 6.91 percentage points (95% CI, 5.35-8.46) in the individuals aged 18 to 24 years and peaking at 10.74 percentage points (95% CI, 8.92-12.55) in individuals aged 50 to 59 years. Black individuals also had a higher prevalence of long sleep duration than White individuals across all age groups.

There were some limitations to this study. Sleep duration was self-reported, which may be subject to recall and social desirability bias. The researchers also lacked data on subjective sleep quality, efficiency, and timing, which may have provided more in-depth understanding of these disparities. Declining participation in NHIS may have influenced the findings in this study.

The researchers concluded that there were significant differences in sleep duration across race and ethnicity, with the disparities greatest in Black women and young and middle-aged Black adults.

They pointed out that the disparity in sleep duration may have further consequences than unhealthy sleep. “Given the importance of sleep to health, the prevalence of short and long sleep duration may be associated with health disparities,” they wrote.

The investigators called for efforts to eliminate the socioeconomic and health conditions that may keep minority individuals from getting adequate sleep.

Reference

Caraballo C, Mahajan S, Valero-Elizondo J, et al. Evaluation of temporal trends in racial and ethnic disparities in sleep duration among US adults, 2004-2018. JAMA Netw Open. 2022;5(4):e226385. doi:10.1001/jamanetworkopen.2022.6385