Optimal sleep is integral to health but is commonly not obtained. Despite its wide-ranging public health impact, sleep health is considered only rarely by policy makers, employers, schools, and others whose policies and structures can adversely affect sleep. An inadequate duration of sleep and poor-quality sleep are prevalent in minority and low-income populations, and may be fundamental to racial and socioeconomic status inequities that contribute to a range of health conditions, including cardiovascular disease (CVD). This review examines the relationship between sleep and disparities in CVD. We describe the public health importance of sleep and the role of sleep duration, as well as the two most common disorders (sleep apnea and insomnia) as risk factors for a number of chronic diseases. We use a multilevel model focused on population health and health disparities, which is based on the notion that individual behaviors, such as sleep, are influenced by complex and dynamic interrelations among individuals and their physical and social environments. We also describe modifiable factors that contribute to insufficient sleep and circadian misalignment, propose potential interventions in various sectors (e.g., neighborhoods, schools, workplaces) that can address social structures that contribute to disparities, and recommend areas for future research. Integrating sleep into public health research will identify novel approaches for closing gaps in health disparities.


Article metrics loading...

Loading full text...

Full text loading...


Literature Cited

  1. Adenekan B, Pandey A, McKenzie S, Zizi F, Casimir GJ, Jean-Louis G. 1.  2013. Sleep in America: role of racial/ethnic differences. Sleep Med. Rev. 17:255–62 [Google Scholar]
  2. Albert MA, Glynn RJ, Buring J, Ridker PM. 2.  2006. Impact of traditional and novel risk factors on the relationship between socioeconomic status and incident cardiovascular events. Circulation 114:2619–26 [Google Scholar]
  3. Alvarez GG, Ayas NT. 3.  2004. The impact of daily sleep duration on health: a review of the literature. Prog. Cardiovasc. Nurs. 19:56–59 [Google Scholar]
  4. Ancoli-Israel S. 4.  2009. Sleep and its disorders in aging populations. Sleep Med. 10:Suppl. 1S7–11 [Google Scholar]
  5. Anderson NB, Bulatao RA, Cohen B. 5.  2004. Critical Perspectives on Racial and Ethnic Differences in Health in Late Life Washington, DC: Natl. Acad. Press
  6. Archbold KH, Giordani B, Ruzicka DL, Chervin RD. 6.  2004. Cognitive executive dysfunction in children with mild sleep-disordered breathing. Biol. Res. Nurs. 5:168–76 [Google Scholar]
  7. Baker FC, Wolfson AR, Lee KA. 7.  2009. Association of sociodemographic, lifestyle, and health factors with sleep quality and daytime sleepiness in women: findings from the 2007 National Sleep Foundation “Sleep in America Poll”. J. Women's Health(Larchmt) 18:841–49 [Google Scholar]

Data & Media loading...

  • Article Type: Review Article
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error