How inequality is affecting sleep quality among disadvantaged families

Our health care system suffers from exorbitant costs yet structural inequalities that disadvantage the most deserving, as the COVID crisis, which disproportionately affects African-Americans and other socioeconomically disadvantaged minorities, uncovered. 

One of the areas where health care disparities are especially apparent is pregnancy, maternal care and sleep, in particular in new parents. Not only are African-American women twice as likely to deliver preemies, their babies receive worse care in the NICU than their white counterparts. Poverty and race independently increase the risk to develop postpartum depression, which affects a mother’s ability to care for her child, with long term repercussions for both mother and child. 

A factor which is often overlooked in the physical and mental struggle of the mother-infant dyad is parental sleep deprivation. African-Americans and other minorities sleep worse than whites, which is in part due to racial discrimination and depression, which in itself aggravates sleep, creating a negative feedback loop. In addition, it has been shown that African-American and hispanic babies, children and adolescents exhibit a higher likelihood of disrupted sleep, yet receive less treatment for it, further affecting the child’s and parents’ sleep and well-being. 

Many of the factors I as a sleep scientist consider crucial for good nighttime sleep in young children show race-dependent differences, which likely contribute to overall worse sleep in underprivileged minorities, in particular with young children. Regular sleep schedules, bedtime routines, avoiding bed-sharing, avoiding TV before bedtime and restricting napping all have been scientifically shown to promote better sleep in children (and adults); however all these practices exhibit lower adoption in low-income and racial/ethnic minority families.

Sleep is a fundamental physiological need, the lack of which contributes to a plethora of physical health problems including diabetes, heart diseases and obesity, as well as mental pathologies including cognitive deterioration and mood disorders, including depression. Being sleep deprived increases the likelihood of being in a car accident, causes memory deficits and reduces our reaction time, all of which affect our function in the workplace and at home. It really all starts with sleep, and providing under-served communities with the tools - whether via educational efforts or manpower - to apply some of the knowledge from sleep science to their own families could alleviate some of the immense pressure they are exposed to on a day-to-day basis towards more restful sleep, thereby increasing health and overall well-being.

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