Racial, Ethnic Disparities Identified in Sleep Quality, Duration of Sleep During Perinatal Stages

Maristella Lucchini, PhD

Although poor sleep is common during pregnancy, new data from the Environmental influences on Child Health Outcomes (ECHO) program identified several disparities among racial groups on sleep duration, sleep quality, and sleep disturbances. In analyses controlling for education strata, differences persisted within the subsample of women with high socioeconomic status.¹

Lead author Maristella Lucchini, PhD, research assistant, Columbia University Irving Medical Center, and colleagues concluded that "given the stark racial/ethnic disparities in perinatal outcomes and their associations with sleep health, further research is warranted to investigate the determinants of these disparities, such as downstream effects of systemic and structural discrimination."

Presented at the 2022 SLEEP Annual Meeting, June 4-8, in Charlotte, North Carolina, the analysis categorized patients based on self-reporting as either non-White (nHW), non-Hispanic Black/African American (nHB/AA), Hispanic, and non-Hispanic Asian (nHA). Using the Pittsburgh Sleep Quality Index and the ECHO maternal sleep health questionnaire, investigators examined trimester-specific nocturnal sleep duration, sleep quality, and sleep disturbances. Associations between race/ethnicity and each sleep domain by trimester were calculated using linear or multinominal regression models, controlling for body mass index and age.

A total of 1119, 2409, and 1284 participants in the first (T1), second (T2), and third trimesters (T3) reported on sleep duration. Compared with nHW participants, nHB/AA individuals reported shorter sleep duration (T2: ß = –0.55 [95% CI, –0.80 to –0.31]; T3: ß =–0.65 [95% CI, –0.99 to –0.31]). In contrast, Hispanic participants reported longer duration compared with nHW (T1: ß = 0.22 [95% CI, 0.00004-0.44]; T2: ß = 0.61 [95% CI, 0.47-0.76]; T3: ß = 0.46 [95% CI, 0.22-0.70]).

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nHB/AA participants also reported more sleep disturbances (T2: ß = 1.92 [95% CI, 1.09-2.75]; T3: ß = 1.41 [95% CI, 0.09-2.74]) compared with nHW individuals, whereas Hispanic participants reported fewer sleep disturbances (T2: ß = –0.5 [95% CI, –1.0 to –0.12]; T3: ß = –1.21 [95% CI, –2.07 to –0.35]). Additionally, Hispanic participants also showed better sleep quality (compare to very good quality odds ratio [OR] for fairly good T1: OR, 0.48 [95% CI, 0.32-0.73]; T2: OR, 0.36 [95% CI, 0.26-0.48]; T3: OR, 0.31 [95% CI, 0.18-0.52]; fairly bad T1: OR, 0.27 [95% CI, 0.16-0.44]; T2: OR, 0.46 [95% CI, 0.31-0.67]; T3: OR, 0.31 [95% CI, 0.17-0.55]).

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REFERENCE
1. Lucchini M, O’Brien, Kahn L, et al. Sleep disparities by race/ethnicity during pregnancy: an environmental influences on child health outcomes (ECHO) study. Presented at: SLEEP Annual Meeting, 2022; June 4-8. Charlotte, NC. Abstract 0060