Disparities in Sleep Health and Potential Intervention Models

Abstract

Disparities in sleep health are important but under-recognized contributors to health disparities. Understanding the factors contributing to sleep heath disparities and developing effective interventions are critical to improving all aspects of heath. Sleep heath disparities are impacted by socio-economic status, racism, discrimination, neighborhood segregation, geography, social patterns and access to healthcare as well as by cultural beliefs necessitating a cultural appropriateness component in any intervention devised for reducing sleep health disparities. Pediatric sleep disparities require innovative and urgent intervention to establish a foundation of lifelong healthy sleep. Tapping the vast potential of technology in improving sleep health access may be an underutilized tool to reduce sleep heath disparities. Identifying, implementing, replicating and disseminating successful interventions to address sleep disparities have the potential to reduce overall disparities in health and quality of life.

Reply to Spector and Iweala

“…A primary goal of our work was to investigate the association between neighborhood-level exposures and CPAP adherence, given evidence that differences in social and physical environments are important drivers of racial health disparities due to the legacy of residential segregation ( 3 , 4 ). Our results support the contention that neighborhood-level factors contribute to disparities in CPAP adherence and highlight the importance of identifying and addressing community-level barriers—rather than solely focusing on the individual—to achieve health equity in sleep medicine ( 5 ).…”

Disparities in Sleep Health and Potential Urban Interventions

“…Indeed, the resulting increase in neighborhood-level affluence may exclude vulnerable residents from benefiting from these changes. 1 Gentrification in vibrant chestjournal.org…”

“…I read with great interest the focused review by Billings et al 1 on sleep health disparities in CHEST (March 2021). In their review, the authors well articulate the need to understand the factors that contribute to sleep health disparities, including neighborhood and ecologic features, and the need to develop interventions that improve sleep health.…”

The Legacy of Racial and Ethnic Segregation on Health: The Story of Continuous Positive Airway Pressure Use

“…Shorter duration of sleep, more fragmented sleep, delayed sleep onset, and poorer quality sleep are more common in non-white populations ( 3 ). Disparities in obstructive sleep apnea (OSA) recognition, diagnosis, and treatment have also been identified by race, ethnicity, and socioeconomic status (SES) ( 4 ). Results from observational cohort studies and clinical trials suggest that adherence to positive airway pressure (PAP), the most effective treatment for OSA, differs by race and ethnicity ( 5 , 6 ).…”