Johnson Dayna A, Jackson Chandra L, Williams Natasha J, Alcántara Carmela
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.
Nat Sci Sleep. 2019 Jul 23;11:79-95. doi: 10.2147/NSS.S169312. eCollection 2019.
Sleep is a fundamental necessity of life. However, sleep health and sleep disorders are not equitably distributed across racial/ethnic groups. In fact, growing research consistently demonstrates that racial/ethnic minorities are more likely to experience, for instance, shorter sleep durations, less deep sleep, inconsistent sleep timing, and lower sleep continuity in comparison to Whites. However, racial/ethnic disparities in reports of sleepiness and sleep complaints are inconsistent. Racial/ethnic groups have significant heterogeneity, yet within-group analyses are limited. Among the few published within-group analyses, there are differences in sleep between non-US-born and US-born racial/ethnic groups, but the group with the more favorable sleep profile is consistent for non-US-born Latinos compared to US-born Latinos and Whites but unclear for other racial/ethnic minority groups. These sleep health disparities are a significant public health problem that should garner support for more observational, experimental, intervention, and policy/implementation research. In this review, we 1) summarize current evidence related to racial/ethnic disparities in sleep health and within-group differences, focusing on the sleep of the following racial/ethnic minority categories that are defined by the United States Office of Management and Budget as: American Indian/Alaska Native, Asian, African American/Black, Hispanic/Latino, and Native Hawaiian/Pacific Islander; 2) discuss measurement challenges related to investigating sleep health disparities; 3) discuss potential contributors to sleep health disparities; 4) present promising interventions to address sleep health disparities; and 5) discuss future research directions on intersectionality and sleep health.
睡眠是生命的一项基本需求。然而,睡眠健康和睡眠障碍在不同种族/族裔群体中的分布并不均衡。事实上,越来越多的研究一致表明,与白人相比,种族/族裔少数群体更有可能经历,例如,睡眠时间较短、深度睡眠较少、睡眠时间表不规律以及睡眠连续性较低等情况。然而,在嗜睡和睡眠问题报告方面的种族/族裔差异并不一致。种族/族裔群体具有显著的异质性,但群体内部分析有限。在少数已发表的群体内部分析中,非美国出生和美国出生的种族/族裔群体之间存在睡眠差异,但与美国出生的拉丁裔和白人相比,非美国出生的拉丁裔睡眠状况更优,而其他种族/族裔少数群体的情况尚不清楚。这些睡眠健康差异是一个重大的公共卫生问题,应该获得更多观察性、实验性、干预性以及政策/实施研究方面的支持。在本综述中,我们:1)总结与睡眠健康方面的种族/族裔差异以及群体内部差异相关的当前证据,重点关注美国管理和预算办公室定义的以下种族/族裔少数群体类别中的睡眠情况:美洲印第安人/阿拉斯加原住民、亚裔、非裔美国人/黑人、西班牙裔/拉丁裔以及夏威夷原住民/太平洋岛民;2)讨论与调查睡眠健康差异相关的测量挑战;3)讨论睡眠健康差异的潜在影响因素;4)介绍解决睡眠健康差异的有前景的干预措施;5)讨论关于交叉性和睡眠健康的未来研究方向。