Temporal Trends in Racial and Ethnic Disparities in Sleep Duration in the United States, 2004–2018
Authors: Caraballo César , Mahajan Shiwani , Valero-Elizondo Javier , Massey Daisy , Lu Yuan , Roy Brita , Riley Carley , Annapureddy Amarnath R. , Murugiah Karthik , Elumn Johanna , Nasir Khurram , Nunez-Smith Marcella , Forman Howard P. , Jackson Chandra L. , Herrin Jeph , Krumholz Harlan M. 
Published: November 2021

Importance

Minoritized racial and ethnic groups are generally more likely to experience sleep deficiencies. It is unclear how these sleep duration disparities have changed over recent years.

Objective

To determine 15-year trends in the racial and ethnic differences in self-reported sleep duration among adults in the US.

Design

Serial cross-sectional study of the National Health Interview Survey from years 2004– 2018. Analyses were performed between July 26, 2021 and February 10, 2022.

Setting

US population-based.

Participants

429,195 non-institutionalized adults.

Exposures

Self-reported race, ethnicity, household income, and sex/gender.

Main Outcomes

Temporal trends and racial/ethnic differences in short- and long-sleep duration (<7 and >9 hours in a 24-hour period, respectively), and racial/ethnic differences in the relationship between sleep duration and age.

Results

The study sample consisted of 429,195 individuals (mean age 46.5 [SE, 0.08] years; 51.7% female) of which 5.1% identified as Asian, 11.8% as Black, 14.7% as Latino/Hispanic, and 68.5% as White. In 2004, the adjusted estimated prevalence of short-sleep duration and long-sleep duration, respectively, were 31.3% and 2.5% among Asian individuals, 35.3% and 6.4% among Black individuals, 27.0% and 4.6% among Latino/Hispanic individuals, and 27.8% and 3.5% among White individuals. Over the study period, there was a significant increase in the short sleep prevalence among Black, Latino/Hispanic, and White individuals (P≤0.001 for each), whereas prevalence of long sleep changed significantly only among Latino/Hispanic individuals (−1.4 points, P=0.01). In 2018, compared with White individuals, short sleep prevalence among Black and Latino/Hispanic individuals was higher by 10.7 points and 2.4 points, respectively

(P≤0.03 each), and long sleep prevalence was higher only among Black people (+1.4 points; P=0.01). The short-sleep disparities were the greatest among women and among those with middle/high household income. In addition, across age groups, Black individuals had a higher short- and long-sleep duration prevalence compared with White individuals of their same age.

Conclusions

In this serial cross-sectional study from 2004 to 2018, the prevalence of short and long sleep duration was persistently higher among Black individuals. The Black-White disparities in short-sleep were highest among women, individuals who had middle or high income, and among young or middle-aged adults.

KEY POINTS

Question

How have racial and ethnic differences in self-reported sleep duration among US adults changed between 2004 and 2018?

Findings

In this serial cross-sectional study that included 429,195 adults, the prevalence of both short and long sleep duration were persistently higher among Black individuals over the 15-year study period. The disparities in short sleep duration were highest for Black women, Black individuals with middle or high income, and young and middle-aged Black adults.

Meaning

There were marked racial and ethnic differences in sleep duration that persisted from 2004 to 2018, which may be contributing to health disparities.