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skeletal health education that will be incorporated 
into first-year orientation or core courses. 
(2) Creating innovative technology-based ap-
proaches to deliver arthritis and musculoskeletal 
health education to students, faculty, and staff. 
(3) Developing and employing peer-outreach 
and education programs to generate discussion, edu-
cate, and raise awareness among students about 
issues relating to arthritis and musculoskeletal 
health disorders, and their relationship to diabetes, 
hypertension, cardiovascular disease, psychological 
health, and other co-morbid conditions. 
(f) REPORT TO CONGRESS.— 
(1) IN GENERAL.—Not later than 1 year after 
the date of the enactment of this Act, and annually 
thereafter for a period of 5 years, the Secretary shall 
prepare and submit to the appropriate committees of 
Congress a report on the activities to provide health 
professions students with comprehensive arthritis 
and musculoskeletal health education funded under 
this section. 
(2) REPORT ELEMENTS.—The report described 
in paragraph (1) shall include information about— 
(A) the number of entities that are receiv-
ing grant funds; 
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(B) the specific activities supported by 
grant funds; 
(C) the number of students served by 
grant programs; and 
(D) the status of program evaluations. 
Subtitle I—Sleep and Circadian 
Rhythm Disorders 
SEC. 791. SHORT TITLE; FINDINGS. 
(a) SHORT TITLE.—This subtitle may be cited as the 
‘‘Sleep and Circadian Rhythm Disorders Health Dispari-
ties Act’’. 
(b) FINDINGS.—The Congress finds the following: 
(1) Decrements in sleep health such as sleep 
apnea, insufficient sleep time, and insomnia, affect 
50–70 million United States adults. Twelve to eight-
een million United States adults have sleep apnea, a 
chronic disorder characterized by one or more 
pauses in breathing which can last from a few sec-
onds to minutes. They may occur 30 times or more 
an hour, disrupting sleep and resulting in excessive 
daytime sleepiness and loss in productivity. 
(2) Seventy percent of high school students are 
not getting enough sleep on school nights, while 33 
percent of Americans get fewer than 7 hours of sleep 
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per night and roughly 6,000 fatal motor vehicle 
crashes are caused by drowsy drivers. 
(3) Insufficient sleep and insomnia are more 
prevalent in women. Women who are pregnant and 
have sleep apnea are at an increased risk of cardio-
vascular complications during pregnancy. The im-
pact of disparities in sleep health is associated with 
a growing number of health problems, including the 
following: 
(A) Hypertension. 
(B) Cancer. 
(C) Stroke. 
(D) Cardiac arrhythmia. 
(E) Chronic heart failure and heart dis-
ease. 
(F) Diabetes. 
(G) Cognitive functioning and behavior. 
(H) Depression and bipolar disorder. 
(I) Substance abuse. 
(4) A ‘‘sleep disparity’’ exists in that poor sleep 
quality is strongly associated with poverty and race. 
Factors such as employment, education, and health 
status, amongst others, significantly mediated this 
effect only in poor subjects, suggesting a differential 
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vulnerability to these factors in poor relative to non- 
poor individuals in the context of sleep quality. 
(5) African-Americans sleep worse than Cauca-
sian Americans. African-Americans take longer to 
fall asleep, report poorer sleep quality, have more 
light and less deep sleep, and nap more often and 
longer. 
(6) African-Americans and individuals in lower 
socioeconomic status groups may be at an increased 
risk for sleep disturbances and associated health 
consequences. 
(7) Among young African-Americans, the likeli-
hood of having sleep disordered breathing and exhib-
iting risk factors for poor sleep is twice that in 
young Caucasians. Frequent snoring is more com-
mon among African-American and Hispanic women 
and Hispanic men compared to non-Hispanic Cauca-
sians, independent of other factors including obesity. 
(8) African-Americans with sleep disordered 
breathing develop symptoms at a younger age than 
Caucasians but appear less likely to be diagnosed 
and treated in a timely manner. This delay may at 
least in part be due to reduced access to care. 
(9) Sleep loss contributes to increased risk for 
chronic conditions such as obesity, diabetes, and hy-
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pertension, all of which have increased prevalence in 
underserved, underrepresented minorities. Racial 
and ethnic disparities related to obesity may also 
contribute to disparities in health outcomes related 
to sleep disordered breathing. 
(10) Non-Caucasian adults report an insomnia 
rate of 12.9 percent compared to only 6.6 percent 
for Caucasians. 
(11) African-American women have a higher in-
cidence of insomnia than African-American men, 
perhaps related in part to higher risk for chronic 
persisting symptoms. 
SEC. 792. SLEEP AND CIRCADIAN RHYTHM DISORDERS RE-
SEARCH ACTIVITIES OF THE NATIONAL IN-
STITUTES OF HEALTH. 
(a) IN GENERAL.—The Director of the National In-
stitutes of Health, acting through the Director of the Na-
tional Heart, Lung, and Blood Institute, shall— 
(1) continue to expand research activities ad-
dressing sleep health disparities; and 
(2) continue implementation of the ‘‘NIH Sleep 
Disorders Research Plan’’ across all institutes and 
centers of the National Institutes of Health to im-
prove treatment and prevention of sleep health dis-
parities. 
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