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

ABSTRACTImportanceMinoritized 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.ObjectiveTo determine 15-year trends in the racial and ethnic differences in self-reported sleep duration among adults in the US.DesignSerial cross-sectional study of the National Health Interview Survey from years 2004– 2018. Analyses were performed between July 26, 2021 and February 10, 2022.SettingUS population-based.Participants429,195 non-institutionalized adults.ExposuresSelf-reported race, ethnicity, household income, and sex/gender.Main OutcomesTemporal 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.ResultsThe 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.
ConclusionsIn 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 POINTSQuestionHow have racial and ethnic differences in self-reported sleep duration among US adults changed between 2004 and 2018?FindingsIn 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.MeaningThere were marked racial and ethnic differences in sleep duration that persisted from 2004 to 2018, which may be contributing to health disparities.