Sleep in Healthy Black and White Adolescents

Abstract

BACKGROUND AND OBJECTIVES: Inadequate sleep among adolescents has negative consequences for self-regulation, emotional well-being, and risk behaviors. Using multiple assessment methods, we evaluated the adequacy of sleep among healthy adolescents from a lower socioeconomic community and expected differences by race. METHODS: A total of 250 healthy high school students enrolled in public school (mean age: 15.7 years; 57% black, 54% female) from families of low to middle class according to the Hollingshead scale participated in weeklong assessments of sleep duration and fragmentation, assessed by using actigraphy; sleep duration and perceived quality, assessed by using daily diaries; and daytime sleepiness and sleep delay, assessed by using a questionnaire. RESULTS: Students slept during the school week a mean ± SD of 6.0 ± 0.9 hours per night according to actigraphy and 6.8 ± 1.1 hours according to daily diary, and during the weekend, a mean of 7.4 ± 1.2 and 8.7 ± 1.4 hours, respectively. Black participants and male participants slept less and had more fragmented sleep; female participants reported poorer quality of sleep in their daily diaries and more daytime sleepiness. The results remained significant after adjustments for age, physical activity, smoking status, and percentile BMI. CONCLUSIONS: Most students slept less than the 8 to 9 hours suggested by the guidelines of the Centers for Disease Control and Prevention. Black male participants had the least amount of sleep, which may play a role in the substantial risks experienced by this demographic group. Our findings are consistent with recommendations that pediatricians should routinely screen their adolescent patients about their sleep, especially those from at-risk subgroups.

Adolescent sleep disparities: sex and racial/ethnic differences

“…Results were in agreement with those of previous research showing that African Americans have shorter sleep durations than Whites, 24,32,33,49 but this effect was only significant in females. The findings that, among males, Hispanic students slept less than both Asian and White students were unique.…”

“…27 Conversely, studies of Turkish children, urban adolescents and high school students found girls slept longer than boys. 28,32,33 Still, other studies found no differences between young adolescent (ie, age 11-14 years) or high school (ie, age 14-18 years) boys and girls. [29][30][31] Limited research exists examining sleep disparities among adolescents of different race/ethnicity groups.…”

“…Most existing literature examines differences in sleep between African American and White groups and shows that African American students sleep less than White students. 32,33 Fewer studies examine sleep disparities in other race/ethnicities. Existing evidence shows that African American and Asian students sleep less than White and Hispanic students, 34,35 with mixed results between Hispanic and White children.…”

Physiology and assessment as low-hanging fruit for education overhaul

“…Results were significant even after adjustments for age, body mass index, physical activity, and smoking status. Black male students showed the least amount of sleep, which the authors hypothesized could be related to the increased risks suffered by this cohort (Matthews, Hall, and Dahl 2014). A recent large-scale cross-sectional study of 20,222 undergraduate students from 27 universities in 26 low-or middle-income countries across the Americas, Africa, and Asia showed that 10.4% of the subjects reported major sleeping problems, with a wide variation (3.0-32.9%) among countries (Peltzer and Pengpid 2015).…”

“…Using actigraphy, daily diaries, and questionnaires, a study evaluated 250 U.S. public high school students (mean age: 15.7 years) for sleep problems; these students were of low or middle SES (Matthews, Hall, and Dahl 2014). Most students showed less sleep than the 8-9 h recommended by the Centers for Disease Control and Prevention.…”