As if it weren’t enough that Black Americans are subject to a range of health disparities that are rooted in systemic racism, studies point to yet another long-standing disparity in sleep patterns that has serious health and quality of life implications.
Having trouble sleeping? You’re not alone. According to a study by the Centers for Disease Control, Black people in America are 58% more likely to get less sleep each night than they need to maintain optimum health as compared to white people. On the other end of the sleep spectrum, Black people are 62% more likely than white people to sleep more than 9 hours a night. Both sleeping too little and sleeping too much can cause health problems. The sweet spot for most adults is 7 to 9 hours a night.
Quality sleep is a basic human need, as important as food and water and researchers say that the physical consequences of not getting enough quality sleep range from increased levels of heart disease, diabetes, stroke, kidney disease, high blood pressure and obesity. Lack of sleep has also been linked to a higher chance of non-alcohol-related car accidents, falls and even plane and train crashes, among other catastrophic workplace accidents.
Not enough or poor quality sleep also leads to mental health impacts including depression, increased anxiety, and inappropriate or negative responses to stress. Lack of sleep influences the ability to perceive the world accurately and can lead to increased violent behavior and suicide. Not getting enough sleep impairs cognition, the ability to focus, and concentration and can lead to a higher risk of dementia.
In fact, disordered sleep may be one of the underlying causes for many of the health disparities that American Black people experience. But even that is impacted by systemic racism.
According to the National Institutes of Health: “Experiences of racial discrimination are common for Black Americans and have been associated with depression and sleep disturbance, factors likely involved in the insidious development of health disparities.”
The federal agency further asserts that Black Americans frequently experience multiple chronic stress:
“…resulting from both institutionalized racism (e.g., lower socioeconomic status) housing and food insecurity, neighborhood disadvantage; and interpersonal racism (i.e., perceived everyday experiences of discrimination). Structural racism and internalized schemas linked to repeated social messages about race can reinforce experiences of interpersonal racism, resulting in messages of exclusion, disempowerment, and devaluation and potentiating biological consequences as well as consequences for sleep.”
But short of the immediate dismantling of white supremacy and the instantaneous healing of generations of trauma, there are some clear actions that most people can take to improve their sleep and thereby positively increase good health and overall enjoyment of life.
According to Ike Ekekwe, MD, a sleep medicine doctor in Atlanta, Georgia, it’s important to pinpoint the type of sleep disturbance you may be experiencing.“Some people find it very difficult to fall asleep. Usually, when you get to a comfortable sleeping position and a comfortable environment, you should be able to fall asleep within half an hour. That’s about average, anything more than that we call that sleep onset insomnia.”
He also cited sleep maintenance insomnia, a situation where you fall asleep, wake up and not be able to fall asleep within a short period of time, and obstructive sleep apnea. “OSA is a debilitating sleep disorder characterized mainly by people having interruptions in their breathing where they, you know, find it difficult to maintain smooth, sleeping patterns. They have periods where their tongue (will) fall back, close the airways, and then they wake up gasping for air.”
For the first two issues, difficulty falling asleep and difficulty falling back to sleep after awakening at night, a good sleep hygiene routine is essential. “We always advise everyone to try not to look at their phones and computers later in the evening,” Dr. Ikekwe says. “Because the LED lights from screens, including the TV, is sending the message to the pineal gland in your brain to not produce the melatonin you need to fall asleep.”
He also mentioned going to bed earlier and if possible, at the same time every evening, even on the weekends. “Keep the room cool, dark and quiet,” he advised. “Some people like to keep the television on, not to watch but for background noise. In that case, we suggest they use a white noise device.” For obstructive sleep disorders, which can be characterized by snoring and periods of time without breathing followed by gasping for air, making an appointment to see a sleep specialist is extremely important. Left untreated, OSA can cause major health problems.
Daily exercise helps, and there are light stretches that, done at bedtime, can help facilitate a good night’s sleep. Avoid large meals, caffeine and alcohol before bed and try to put work aside to spend this time as self-care, enjoying your family and engaging in a quiet activity that doesn’t involve screens of any kind. It’s a tall order, but the payoff in the extra energy, mental clarity and emotional resilience is well worth it.
Dr. Ikekwe recognizes that for many, these sleep solutions are easier said than done, especially for people of color and poor people who work non-standard schedules. “When we look at sleep patterns in America, brown and Black people tend to do more hourly jobs that entail going to work in the evening and getting off work in the morning,” he noted. “Those jobs are very necessary to run the economy in the country, but you know, that’s not natural and overall, it is going to negatively affect your health long-term.”
But Black managerial, executive and entrepreneur workers are not immune either. “Of course, people who have high-level jobs that come with a lot of stress, often are not able to release that stress when the workday is over, they take their jobs home and continue working. I don’t think (it) is more skewed toward African Americans. I think it’s skewed toward Type A personality people who have high-level, high-stress jobs,” Ekekwe said. Racial stress and unreasonable expectations are layered on top of that.
Ultimately, as always, we have to empower ourselves to be well, taking the steps by any means necessary to engage in a life-affirming, health-promoting lifestyle, eating well, moving our bodies, cultivating healthy relationships, resting and sleeping.
In her book Rest is Resistance: A Manifesto, Tricia Hersey, founder of Atlanta-based The Nap Ministry writes that “Capitalism was created on plantations. The roots of it are violence and theft. We as a culture gloss over this historical truth. But, to dive into the cracks of this reality is where a profound part of your deprogramming from grind culture resides…To be colonized is to accept and buy into the lie of our worth being connected to how much we get done…We must rest.”