Sleep Matters

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Disparities in Sleep Health and Potential Interventions

Disparities in Sleep Health and Potential Intervention Models

Disparities in health outcomes are major concerns as we strive to improve population health. Dr. Billings and co-authors recently presented a focused review of sleep health disparities in the journal CHEST. The authors review existing disparities and potential interventions to reduce those disparities in three areas: 1) sleep quality, 2) diagnosis of sleep apnea, and 3) pediatric sleep. 

Sleep Quality: The authors highlight consistent findings of shorter sleep duration and fragmentation among Black, Latinx, Asian, and indigenous non-white adults. The authors note investigations linking poor sleep quality to adverse ecological and neighborhood features (e.g. ambient noise, air quality and heat) caused by housing policies that reinforced segregation, stress related to discrimination and psychosocial trauma, and differential employment factors (e.g. shiftwork). Regarding interventions, the authors outline the importance of pursuing policies to eliminate segregation and reduce barriers to geographic features that may promote better sleep (e.g. green space), and discuss several small trials that target behavioral health interventions in low-income communities.

Sleep Apnea: Dr. Billings and her co-authors discuss the large prevalence of unrecognized and untreated sleep apnea among Black and Latinx populations, and discuss how this relates to pervasive issues around access to high quality healthcare. The authors explore potential interventions related to empowerment of non-sleep specialists to provide care for sleep apnea (e.g. primary care providers) and “peer buddies” to support adherence to positive airway pressure therapy. The authors also cite the potential benefits of telemedicine to reduce travel/time demands of patients, but acknowledge limitations in the setting of the “digital divide”.

Pediatric Sleep: The authors outline research around how much of the evidence highlighted for adults in the sections above are also salient for the pediatric population, outlining research demonstrating short duration and lower quality sleep among Black and Latinx children  relative to non-Latinx white peers. As interventions, the authors explore such possible interventions as integrating behavioral health providers into primary care, and addressing sleep as part of supportive housing efforts.

As we strive to improve sleep health across our population, it is essential that we confront these major disparities.

Read the full article here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7525655/

(Post by: Luke Donovan)