Sleep: Everyone Needs It, but Who Gets It?

Black man in bed awake, hands clasped on foreheadDebbie says:

Katherine Ellison’s article, “The Great Sleep Divide,” in Knowable Magazine/Ars Technica, applies a race and class analysis to the human need for sleep. While her findings are not surprising, they are troubling … and valuable.

it turns out that the poor, as well as socially disadvantaged racial minorities, sleep much less well on average than the rich, which can take a major toll on their physical and mental health.

As Ellison explains, lack of sleep is a major problem in the United States: huge percentages of adults and teens don’t get the recommended number of hours of sleep, and a quarter of  us suffer from actual insomnia (this got worse during the pandemic, as you might expect). And lack of sleep has long been known to have long-term, sometimes catastrophic, health effects, including increases in frequency of cardiovascular disease and dementia.

Researchers have only comparatively recently started to delve into the socioeconomic factors that impact sleep:

Over the years, researchers repeatedly have found evidence that people in poverty get less sleep than those with more money. In 2013, for instance, a large CDC survey found that 35.2 percent of people earning below the poverty level reported sleeping less than six hours in an average 24-hour period, compared with 27.7 percent of those earning more than four times the poverty level.

The disparities are even sharper among racial groups. A rigorous 2015 study involving both lab tests and self-reports from more than 2,000 US participants found that, compared with whites matched for age and sex, Blacks were five times as likely to sleep for shorter periods. [About twice as many Hispanics and Chinese Americans get insufficient sleep than whites.] …

As we all know from our own experience, sleep isn’t only quantitative, it’s qualitative:

As [Girardin] Jean-Louis [a sleep researcher at New York University] and other researchers have found, Blacks tend to spend less time than whites in slow-wave sleep, the deep slumber that supports physical and mental health. In a longitudinal study involving home and lab studies of 210 elderly people, including 150 African Americans, Jean-Louis is exploring the degree to which this deficit may contribute to higher rates of heart disease and dementia.

The best thing about Ellison’s article is that it actually addresses solutions and clarifies that sleep issues are systemic and social, not purely individual.

Sleep has traditionally been seen as a purely individual responsibility: don’t drink coffee at night; keep the room dark; don’t look at your phone in bed, etc., etc. [Wendy] Troxel [of the RAND Corporation], Jean-Louis and other scientists argue that we need to widen our perspective to reimagine sleep as a public health opportunity.”

One clearly helpful intervention, not too difficult to implement, is changing school hours (which of course impact parents and teachers as well as students):

Major national debate has focused on one relatively straightforward change, which scientists contend could help tens of millions of Black, white, rich, and poor children and their families sleep better: namely, delaying school start times by as much as an hour. The science is solid. For their physical and mental health, teens need a lot more sleep than they’re getting.

Many school districts that have moved back their starting clocks have seen benefits including more alert students, better academic outcomes, and fewer car accidents. So far, however, fewer than 20 percent of US middle and high schools have made the change, Troxel notes. (When schools closed for the pandemic, many set their remote schedules later, and some surveys of students suggest that this has allowed students more sleep.)

Class and race inequality pervade all aspects of our lives: this is one where we can make improvements both systemically and in our own networks.

Now go get some sleep!

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