7.11 Sleep Disparities

Significant sleep disparities between identity groups exist based on a number of factors. In general, lower socioeconomic status (SES) is associated with shorter sleep duration and lower sleep quality, in part because environmental factors as well as positive social, economic, and psychological skills associated with higher SES help shield against adversity and thus protect sleep (Gellis et al., 2005; Mackenbach & Howden-Chapman, 2003). Factors like food security, access to health care, neighborhood, and immigration status are all parts of SES that can impact physical and mental health and therefore sleep. Further, while poverty has been found to be a stronger predictor of poor sleep compared to race, significant differences in sleep have also been observed between racial and ethnic groups (Patel et al., 2010).  Additionally, researchers have found that that experiences of discrimination and racism have been linked to poorer sleep quality independent of factors like SES or other stressors (Jehan et al., 2018; Slopen & Williams, 2014).

A number of studies have indicated that female college students experience higher rates of sleep difficulties than male students. They generally take longer to fall asleep, experience more awakenings, and report poorer overall sleep quality (Tsai & Li, 2004). This may be at least partly related to higher rates of depression, anxiety, and physical complaints among women—all of which are highly correlated with poor sleep (Piccinelli & Wilkinson, 2000)—but researchers who’ve controlled for such things have also found poorer sleep quality among women (Lindberg et a., 1997; Zhang & Wing, 2006), leading to the belief that other factors—for example, gendered family expectations—contribute to poor sleep, as well (Burgard et al., 2010). Interpersonal factors also play a role in sleep. Exposure to intimate partner violence is predictive of sleep disturbance (Oliver et al., 2013) and caring for an infant or fulfilling another kind of caregiver role can also impact sleep (Insana & Montgomery-Downs, 2013; von Känel et al., 2012), both factors that disproportionately impact females.

Cultures vary widely when it comes to sleep practices, beliefs, and influences, including those around bed sharing, sleep surfaces, attitudes around sleep, attitudes around dreaming, access to technology, work practices and hours, and acceptability of daytime naps. Further, sleep assessments have not yet been well validated across cultures and ethnicities, so it may be that sleep needs differ across these groups and general recommendations may more closely align with one specific group as informed by research to-date (Grandner et al., 2014).