Racial Differences in Self-Reported Sleep Continuity Disturbance, Problem Endorsement, and Daytime Dysfunction Among Black and White Non-Hispanic Adults in the United States

Background: Few studies have assessed sleep across all sleep continuity variables (eg, sleep latency SL, number of awakenings NWAK, wake after sleep onset WASO, early morning awakenings EMA, total sleep time TST, total wake time TWT) concurrently, at the community level, leading to gaps in understanding racial sleep disparities. Moreover, many studies do not examine sleep-related problem endorsement and daytime function. Purpose: To examine race differences in insomnia symptom severity (eg, sleep continuity disturbance SCD), problem endorsement, and daytime dysfunction among Black and White non-Hispanic adults. Participants and Methods: Participants (N=8172) living in Greater Philadelphia completed an online community survey about their sleep between 2011 and 2021. Chi-square and t -test analyses were used to compare sleep-related differences by race. Multiple regression analyses were conducted to investigate the effect of race on sleep, controlling for age, sex, BMI, and education. Results: Black non-Hispanics had significantly worse SL (Δ> 3 min), WASO (Δ> 8.4 min), and TWT (Δ > 12.1 min) but not NWAK (Δ 36.8 min). Appreciable effect sizes ranged from .01 to .44. White non-Hispanics consistently endorsed greater daytime dysfunction with small effects ranging from .07 to .14. Conclusion: Findings suggest that Black non-Hispanics experience less restorative sleep, which can lead to impaired cognitive function, mood disturbances, and increased risk of chronic illness. Observed differences in TST may be due to the unmeasured effects of EMA or to reduced time in bed, underscoring the importance of comprehensive approaches to understanding sleep disturbances like insomnia. Addressing insomnia severity using multidimensional approaches and with targeted interventions, such as Cognitive Behavioral Therapy for Insomnia and/or systematic sleep extension, could help improve sleep health. Moreover, examining differences in sleep across sociodemographic characteristics leads to nuanced understandings that highlight the importance of developing targeted, precision-based behavioral health interventions. Keywords: insomnia, sleep differences, sleep quality, sleep health disparities, Black or African Ancestry