Big Sleep Gap

Lack of sleep destroys the health of the poor and ethnic minorities and gains power.

Do you remember the line of that old song?

If life is something money can buy

then you know that the rich live and the poor die.

Unfortunately, there is very little "if" about it. On average, the poor live healthier lives and are three times more likely to die prematurely than the rich. This is especially true for well-documented reasons, including less healthy diets with over-processed foods, polluted neighborhoods, and more toxic stress. In recent years, researchers have added another factor to the mix: It turns out that the poor, as well as ethnic minorities at risk of social harm, sleep on average much less than the rich, which can be very harmful. . and mental health.

"We used to think that sleep problems were limited to Type A professionals and certainly not immune to them, but people with low incomes and ethnic minorities are actually most at risk." Wendy Troxell, RAND's Senior Behavioral Scientist and Sociologist, contributed to the 2020 Annual Public Health Survey analyzing socioeconomic disparities in sleep and health. Lack of sleep among low-income and ethnic adults Troxell et al notes that minorities contribute to higher rates of disease, including cardiovascular disease and dementia. One study they cited is more than half of the difference in health outcomes between whites and blacks, for example, differences in the amount or quality of sleep. You might think of this as a big sleep gap.

Inequality between health and sleep health

Lack of sleep has become such a widespread complaint that American scientists have been talking about an epidemic of disorders among Americans for years. More than one in three American adults sleeps less than seven hours a night, at least as suggested by the American Academy of Sleep Medicine. About seven in 10 high school students are unable to receive the recommended eight to 10 hours per night for their age group. And each year, one in four Americans suffers from insomnia, while up to 7% of men have obstructive sleep apnea, which can make them feel sleepy during the day. (For many people, sleep disturbances such as insomnia have worsened with the pandemic, and a transfer report reported that nearly 40% of people reported sleep problems in the first half of 2020.

It is still a common assumption That unpleasant sleep, according to Troxell, is a symptom rather than the cause of other medical or psychological problems.However, we know today that even a little sleep can cause illness.People with sleep apnea are more likely to have cardiovascular disease and stroke, as well as Increased inflammation, which may contribute to conditions such as heart disease, cancer, and arthritis.For teens, one study found that missing every hour of sleep was linked to a 23 percent increased risk of smoking, alcohol, or marijuana and a 58 percent increased risk of suicide. enough to make people more vulnerable to viruses and less likely to benefit from vaccines.

But that's a big sleep gap. Over the years, researchers have received repeated evidence from poor people. Less sleep than those with more money. For example , In 2013, I found A large study by the Centers for Disease Control and Prevention (CDC) found that 35.2% of people living below the poverty line reported sleeping less than six hours in a 24-hour period, while 27.7% of those with more than their income earned four times as much as poverty. .


The differences between ethnic groups are even more stark. A close-up study in 2015 involving both testers and a report of more than 2,000 American participants found that, compared to whites in terms of age and gender, they were five times more likely to sleep for shorter periods. Hispanics and Chinese Americans can sleep twice as much as whites.

Many economic, social, and physical factors contribute to these differences and the damages associated with health, school performance, and productivity.

Living in low-income neighborhoods is a risk factor for sleep deprivation, for many reasons including increased noise, noise pollution, and lack of access to green spaces. “It is said that your zip code is just as important as your genetic code,” said Troxell, who has collected evidence that shows that where people live affects their health. He and his colleagues compared groups of residents in basements to the entrances to Pittsburgh, only one of whom received public funding for housing and green spaces. They found that even when both groups of residents sleep less over time - a natural consequence of aging - those who live close to the neighborhood do less well. For African Americans, a much higher percentage of NYU sleep researcher Gerardin Jean Lewis says sleep apnea is disruptive. Federal data shows that one reason for the difference is that non-Hispanic blacks are 1.3 times more likely to be overweight or obese than non-Hispanic whites, and that extra weight can partially interrupt breathing during sleep. During sleep studies, Jean-Louis and his colleagues found people who wake up 200 times a night — a predicament that can turn into a cruel trap. Lack of sleep can affect people's metabolism and even appetite-regulating hormones and lead to unhealthy weight gain.

Stress is an additional barrier to sleep—and it's no surprise that people with financial and economic disabilities are more likely to do so, says Troxell. Financial problems, a lack of relative control over one's life, and systemic racism can interfere with adequate rest.

Blacks, for example, report more work-related stress than whites. Research shows that, on average, they work in jobs that feel less controlled, work in more than one low-paying job at a time, and even live in poverty while working. Ironically, the opposite is true for blacks, even if whites tend to sleep better as they advance in their careers and become more responsible at work. The exact reasons are still unknown, but some researchers call John Henry - the legendary black man the "steel driver" - that blacks are working hard to prove their success. As Jean-Louis and other researchers have found, blacks tend to spend less time than whites in slow-wave, deep sleep that supports physical and mental health. In a longitudinal study that included home and laboratory studies of 210 older adults, including 150 African Americans, Jean-Louis studies the extent to which this deficiency increases rates of heart disease and dementia.

Reasons, sleep deprivation creates a vicious cycle of destruction. Lack of sleep makes people less healthy, which in turn may make it more difficult to sleep. And in another devastating feedback loop, sleep deprivation can contribute to more car crashes and reduced productivity and revenue. Of course, all this gives more reasons to throw and spin. Big Sleep GapBenhard Lang/Getty Images


Putting sleep health front in society

Some of the causes of deep sleep deprivation are frustrating, because Policymakers have been mischievous for decades. Frankly, there is little hope that any of the researchers' key issues, such as poverty, racial discrimination, and environmental injustice, will soon be resolved. However, Troxell and other scientists say the new focus on sleep is a big step forward because it directs them to consider smaller "socio-social" steps to improve sleep health and its consequences. "In many cases, sleep health can be altered," says Rebecca Robbins, a sleep researcher at Harvard Medical School. Troxell, Robins, and Jean-Louis focused on strategies for doing so. In New York City, Jean-Louis has hired hairstylists and church leaders as local ambassadors to spread the word about sleep health. "Patients don't just come to clinics or hospitals," he says. "We have to go to them." Jean-Louis collaborated with Robbins and other researchers to produce sleep apnea video footage of older white men and to include black stories. They installed these videos on their iPads which they distributed to local barbershops and churches.

Given the depth of misunderstanding about co-sleeping and sleep disorders, sleep health education is essential. He says it's often frustrated, for example, by people who insist that snoring is a healthy sign of deep sleep, when more often than not it indicates a problem like sleep apnea. His usual response is to say, "This is God's way of saying there is a problem."

According to Jane Lewis and Troxell, changes in rules and regulations can also go a long way to improving sleep health. Improved local noise guidelines, building codes to reduce light pollution, and more humane night-shift programs, which are more prevalent among African Americans, could help reduce sleep deprivation.

A relatively simple change that scientists say could give tens of millions of black, white, rich and poor children and their families better sleep: delaying the start of school by an hour. Science is solid. Teens sleep a lot more than they want for their physical and mental health. Many school districts that regained their early hours saw benefits such as increased student alertness, improved academic performance, and fewer cars. Accidents However, to date, less than 20 percent of American high schools and high schools have brought about this change. (When schools are closed due to the pandemic, many later adjust their schedule, and some student surveys show this has caused students to sleep more.)

The paradigm shift in all of these sleep strategies is implied. Sleeping is traditionally seen as an entirely personal responsibility: Don't drink coffee at night. make the room dark; Don't look at your phone in bed, etc., etc. Troxell, Jean-Louis, and other scientists believe we need to broaden our view to see sleep as an opportunity for public health. “We need interventions at the grassroots level, including policies to ensure that healthy sleep is not just a luxury for the people who can afford it,” Troxell says. /p>

10.1146 / knowable-061821-2

< p> Kathryn Ellison is a journalist and author of her latest book, Mothers and Killers: A Tale of Love, Lies, Obsession, and Second Chances.

This article was published in Knowable Magazine, an annual independent journalistic effort. Subscribe to our newsletter. Big Sleep Gap

Big Sleep Gap
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