A Workshop Report on the Causes and Consequences of Sleep Health Disparities

Sleep. 2020 Mar 10;zsaa037. doi: 10.1093/sleep/zsaa037. Online ahead of print.

Abstract

Sleep deficiencies, which include insufficient or long sleep duration, poor sleep quality, and irregular timing of sleep, are disproportionately distributed among populations that experience health disparities in the United States. Sleep deficiencies are associated with a wide range of suboptimal health outcomes, high risk health behaviors, and poorer overall functioning and wellbeing. This report focuses on sleep health disparities (SHDs), which is defined as differences in one or more dimensions of sleep health on a consistent basis that adversely affects designated disadvantaged populations. SHDs appear to share many of the same determinants and causal pathways observed for health outcomes with well-known disparities. There also appears to be common behavioral and biological mechanisms that connect sleep with poorer health outcomes, suggesting a link between SHDs and other health disparities observed within these designated populations. In 2018, the National Institute on Minority Health and Health Disparities, the National Heart, Lung, and Blood Institute, and the Office of Behavioral and Social Sciences Research convened a workshop with experts in sleep, circadian rhythms, and health disparities to identify research gaps, challenges, and opportunities to better understand and advance research to address SHDs. The major strategy to address SHDs is to promote integration between health disparity causal pathways and sleep and circadian-related mechanisms in research approaches and study designs. Additional strategies include developing a comprehensive, integrative conceptual model, building transdisciplinary training and research infrastructure, and designing as well as testing multilevel, multifactorial interventions to address SHDs.

Keywords: Epidemiology; Health Disparities; Health Disparity Causal Pathways; Sleep; Sleep and Circadian-Related Mechanisms; Social Determinants.