Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC.
Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD.
Sleep. 2020 Aug 12;43(8). doi: 10.1093/sleep/zsaa037.
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 well-being. This report focuses on sleep health disparities (SHDs), which is a term defined as differences in one or more dimensions of sleep health on a consistent basis that adversely affect 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.
睡眠不足包括睡眠时间不足或过长、睡眠质量差以及睡眠时间不规律,在美国,这些问题在存在健康差异的人群中分布不均。睡眠不足与一系列健康状况不佳、高风险健康行为以及整体功能和幸福感较差有关。本报告重点介绍睡眠健康差异(SHD),这是一个术语,定义为在一致的基础上睡眠健康的一个或多个维度存在差异,从而对指定的弱势群体产生不利影响。SHD 似乎与健康结果的许多相同决定因素和因果途径有关,这些决定因素和因果途径是众所周知的健康差异。似乎也有共同的行为和生物机制将睡眠与较差的健康结果联系起来,这表明 SHD 与这些指定人群中观察到的其他健康差异之间存在联系。2018 年,国家少数民族健康与健康差异研究所、国家心肺血液研究所和行为与社会科学研究办公室召集了一次睡眠、昼夜节律和健康差异方面的专家研讨会,以确定研究差距、挑战和机会,以更好地理解和推进研究以解决 SHD。解决 SHD 的主要策略是在研究方法和研究设计中促进健康差异因果途径与睡眠和昼夜节律相关机制的整合。其他策略包括制定全面的、综合的概念模型,建立跨学科培训和研究基础设施,以及设计和测试多层次、多因素的干预措施来解决 SHD。