Sleep symptoms, race/ethnicity, and socioeconomic position

J Clin Sleep Med. 2013 Sep 15;9(9):897-905; 905A-905D. doi: 10.5664/jcsm.2990.


Study objectives: Growing evidence indicates sleep is a major public health issue. Race/ethnicity and socioeconomics may contribute to sleep problems. This study assessed whether sleep symptoms were more prevalent among minorities and/or the socioeconomically disadvantaged.

Design: Cross-sectional.

Setting: Epidemiologic survey.

Patients or participants: 2007-2008 National Health and Nutrition Examination Survey (N = 4,081).

Interventions: None.

Measurements and results: Sociodemographics included age, sex, race/ethnicity, marital status, and immigration. Socioeconomics included poverty, education, private insurance, and food insecurity. Sleep symptoms assessed were sleep latency > 30 min, difficulty falling asleep, sleep maintenance difficulties, early morning awakenings, non-restorative sleep, daytime sleepiness, snorting/gasping, and snoring. Decreased reported problems for most symptoms were found among minorities, immigrants, and lower education levels. In general, in fully adjusted models, long sleep latency was associated with female gender, being black/African American, lower education attainment, no private insurance, and food insecurity. Difficulty falling asleep, sleep maintenance difficulties, early morning awakenings, and non-restorative sleep were also associated with female gender and food insecurity. Daytime sleepiness was seen in female and divorced respondents. Snorting/gasping was more prevalent among male, other-Hispanic/Latino, and 9(th)- to 11(th)-grade-level respondents. Snoring was prevalent among male, other-Hispanic/Latino, less-educated, and food-insecure respondents.

Conclusions: Sleep symptoms were associated with multiple sociodemographic and economic factors, though these relationships differed by predictor and sleep outcome. Also, reports depended on question wording.

Keywords: Insomnia; health disparities; race/ethnicity; sleep disorders; socioeconomic status.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Age Factors
  • Emigrants and Immigrants / statistics & numerical data
  • Ethnicity / statistics & numerical data*
  • Female
  • Humans
  • Income / statistics & numerical data
  • Male
  • Marital Status
  • Middle Aged
  • Nutrition Surveys / statistics & numerical data
  • Racial Groups / statistics & numerical data*
  • Regression Analysis
  • Sex Factors
  • Sleep Wake Disorders / epidemiology*
  • Sleep Wake Disorders / ethnology
  • Sleep Wake Disorders / etiology
  • Socioeconomic Factors
  • United States / epidemiology