Racial/ethnic disparities in sleep duration and sleep disturbances among pregnant and non-pregnant women in the United States

Lydia Feinstein; Ketrell L McWhorter; Symielle A Gaston; Wendy M Troxel; Katherine M Sharkey; Chandra L Jackson

doi:10.1111/jsr.13000

Racial/ethnic disparities in sleep duration and sleep disturbances among pregnant and non-pregnant women in the United States

J Sleep Res. 2020 Oct;29(5):e13000. doi: 10.1111/jsr.13000. Epub 2020 Feb 29.

Authors

Lydia Feinstein^{1

2}, Ketrell L McWhorter³, Symielle A Gaston⁴, Wendy M Troxel⁵, Katherine M Sharkey^{6

7}, Chandra L Jackson^{4

8}

Affiliations

¹ Social and Scientific Systems, Durham, NC, USA.
² Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
³ School of Science, Health and Mathematics, Asbury University, Wilmore, KY, USA.
⁴ Epidemiology Branch, Department of Health and Human Services, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA.
⁵ Behavioral and Social Sciences, RAND Corporation, Pittsburgh, PA, USA.
⁶ Department of Medicine, Rhode Island Hospital and Alpert Medical School of Brown University, Providence, RI, USA.
⁷ Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA.
⁸ Intramural Program, Department of Health and Human Services, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA.

Abstract

Sleep disturbances among pregnant women are increasingly linked to suboptimal maternal/birth outcomes. Few studies in the USA investigating sleep by pregnancy status have included racially/ethnically diverse populations, despite worsening disparities in adverse birth outcomes. Using a nationally representative sample of 71,644 (2,349 pregnant) women from the National Health Interview Survey (2004-2017), we investigated relationships between self-reported pregnancy and six sleep characteristics stratified by race/ethnicity. We also examined associations between race/ethnicity and sleep stratified by pregnancy status. We used average marginal predictions from fitted logistic regression models to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for each sleep dimension, adjusting for sociodemographic and health characteristics. Pregnant women were less likely than non-pregnant women to report short sleep (PR_Overall = 0.75; 95% CI, 0.68-0.82) and more likely to report long sleep (PR_Overall = 2.06; 95% CI, 1.74-2.43) and trouble staying asleep (PR_Overall = 1.34; 95% CI, 1.25-1.44). The association between pregnancy and sleep duration was less pronounced among women aged 35-49 years compared to those <35 years. Among white women, sleep medication use was less prevalent among pregnant compared to non-pregnant women (PR_White = 0.45; 95% CI, 0.31-0.64), but this association was not observed among black women (PR_Black = 0.98; 95% CI, 0.46-2.09) and was less pronounced among Hispanic/Latina women (PR_{Hispanic/Latina} = 0.82; 95% CI, 0.38-1.77). Compared to pregnant white women, pregnant black women had a higher short sleep prevalence (PR_Black = 1.35; 95% CI, 1.08-1.67). Given disparities in maternal/birth outcomes and sleep, expectant mothers (particularly racial/ethnic minorities) may need screening followed by treatment for sleep disturbances. Our findings should be interpreted in the historical and sociocultural context of the USA.

Keywords: ethnic groups; pregnancy; race factors; sleep; sleep deprivation; sleep initiation and maintenance disorders.

Publication types

Research Support, N.I.H., Intramural

MeSH terms

Adolescent
Adult
Ethnicity / statistics & numerical data*
Female
Humans
Middle Aged
Pregnancy
Prevalence
Racial Groups / statistics & numerical data*
Sleep Wake Disorders / epidemiology*
United States
Young Adult

Abstract

Publication types

MeSH terms

Grants and funding