Linking sleep and racial health disparities: Characterizing sleep architecture in the National Sleep Research Resource

Alycia N. Bisson, PhD

Brigham and Women’s Hospital
Linking sleep and racial health disparities: Characterizing sleep architecture in the National Sleep Research Resource

Scientific Abstract

Background: To address the problem of racial health disparities, prior work has studied differences in environmentally-influenced and modifiable health behaviors, like nutrition, sedentary behaviors. Mounting evidence suggests that sleep plays a key role in health, including cardiometabolic and neurodegenerative disease. Thus, studies have begun to characterize sleep differences across racial groups. We aimed to better quantify differences in objectively measured sleep that may contribute to racial health disparities. As sleep varies markedly between men and women and over the lifecourse, analyses considered age and sex.

Methods: In preliminary analyses, we examined whole-night polysomnography from 728 individuals between the ages of 7 and 86 (M: 41.39, SD: 19.39) in the diverse Cleveland Family Study (45% male, 57% African American). Linear models examined racial differences in a battery of sleep metrics, and tested whether differences changed with age. Microarchitecture metrics included NREM spindle and slow oscillations, important to cognitive-aging and cardiometabolic health.

Results: African Americans spent relatively more time in lighter N2 (b= 0.295, p<.001) and less time in deeper N3 (b= -0.364, p<.001) sleep, and experienced more nighttime awakenings (b= 0.282, p<.001). African Americans had lower NREM spectral power across multiple frequency bands (p<.001), and reductions in several spindle characteristics including amplitude (b = -0.537, p<.001) and density (b = -0.341, p<.001). Metrics showed qualitatively different patterns of interaction with age: e.g., racial differences in N3 duration increased with age, and differences in spindle amplitude decreased with age (interactions p<.001), despite marked age-related reductions across all individuals.

Conclusions: While supporting prior reports of racial differences in gross sleep patterns, we also observed multiple differences in NREM sleep microarchitecture. This work may help to identify specific modifiable aspects of sleep as targets for ameliorating health disparities. Patterns of racial differences over the lifecourse may illuminate different mechanisms being active at different points in development.

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Alycia N. Bisson, PhD, Susan S. Redline, MD, MPH, Shaun M. Purcell, PhD

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