Sleep differences among ethnic groups revealed in new poll

NSF's Sleep in America poll found that more than three-fourths of respondents from each ethnic group agree that poor sleep is associated with health problems (76-83%). These new findings echo lessons learned by former President Bill Clinton who recently admitted that he has adopted a new lifestyle regimen to sleep seven or more hours on the advice of his doctors.

The poll also shows that all groups report disturbingly similar experiences missing work or family functions because they were too sleepy (19-24%). Among married people or couples living together, all ethnic groups report being too tired for sex frequently (21- 26% of the time).

"As the leading voice of sleep health, we are committed to better understanding people's sleep needs," says David Cloud, CEO of the National Sleep Foundation. "By exploring ethnic and family sleep practices we have gained new insight into why we sleep the way we do."

Blacks/African-Americans report the busiest bedtime routines.

Blacks/African-Americans are the most likely to report performing activities in the hour before going to bed every night or almost every night, specifically watching TV (75%) and/or praying or doing another religious practice (71%). Whether on weekdays/workdays or non-workdays/weekends, Blacks/African-Americans spend much more time in bed without sleeping than the other ethnic groups (54 minutes on weekdays/workdays and 71 minutes on non-workdays/weekends).

• Blacks/African-Americans and Hispanics (10% each) are ten times more likely to report having sex every night than Asians (1%) and 2.5 times more likely than Whites (4%).
• Most Blacks/African-Americans report praying every night (71%); more than four times the reported frequency of Asians (18%), twice the rate of Whites (32%) and 1.5 times the rate of Hispanics (45%).
• Blacks/African-Americans (17%) and Asians (16%) are more likely than Whites (9%) and Hispanics (13%) to report doing job-related work in the hour before bed, among those employed.
• Blacks/African-Americans report losing sleep every night over personal financial concerns (12%) and employment concerns (10%) at a higher rate than Whites (6% and 7%) or Asians (1% and 4%). Hispanics are almost equally concerned each night about these two issues (11% and 9%, respectively).

"The hour before bed is an important time to relax and wind-down before going to sleep," says Thomas J. Balkin, Ph.D., Chairman of the National Sleep Foundation. "For those who are having problems sleeping, it's a good idea to consider whether your bedtime routines may be too alerting."

Asians report getting the best sleep, report the least amount of sleep problems and infrequent use of sleep aids.

Asians are the most likely ethnic group (84%) to say that they had a good night's sleep at least a few nights or more a week. In addition, Asians are about half as likely (14%) to discuss their sleep issues with a healthcare professional, and are half as likely (10%) to report having been diagnosed with a sleep disorder. Asians are the least likely to report using sleep medication at least a few nights a week (5% versus 13% Whites, 9% Blacks/African-Americans and 8% Hispanics).

• Asians are the least likely (9%) to say that they "rarely" or "never" have a good night's sleep, compared with 20% of Whites, 18% of Blacks/African-Americans and 14% of Hispanics.
• The poll shows that Asians are more than twice as likely to use the Internet every night in comparison to any other group (51% versus 22% Whites, 20% Blacks/African-Americans, 20% Hispanics). They are also the least likely to watch TV an hour before sleep (52% versus 64% Whites, 72% Hispanics and 75% Blacks/African-Americans).
• Asians report the use of herbal and alternative therapies at rates similar to Hispanics (2% each), but less than Whites (4%).
• Asians report the lowest rates of losing sleep due to personal financial concerns at least a few nights a week (9% versus 22% Hispanics, 20% Whites and 19% Blacks/African-Americans).

While Blacks/African-Americans report the least amount of sleep, they also say they need less sleep. Blacks/African-Americans report getting the least amount of sleep on workdays/weekdays (6 hours and 14 minutes). Interestingly, they also say that they need only 7 hours and 5 minutes of sleep each night to perform at their best during the day, which is significantly less sleep than Asians and Hispanics (7 hours and 29 minutes each).

• Blacks/African-Americans report getting an average of 34 minutes less sleep on a work night/weeknight than Asians and 38 minutes less than Whites.

"The finding that Blacks/African-Americans say they need less sleep and get less sleep is instructive for public health professionals," says Jose S. Loredo, MD, MPH, Professor of Medicine at the University of California, San Diego. "Their total sleep time and attitudes regarding sleep may be associated with Blacks/African-Americans' higher rates of sleep apnea, hypertension and diabetes and provide sleep-related insight into how to improve awareness and education programs and, very importantly, how to improve therapy compliance rates."

Hispanics are the most likely to say they are kept awake by financial, employment, personal relationship and/or health-related concerns.

Overall, at least one-third of Hispanics (38%) and Blacks/African-Americans (33%) report that any of these concerns disturb their sleep at least a few nights a week, compared to about one-fourth of Whites (28%) and/or Asians (25%).

• Moreover, about two in ten Hispanics (19%) and Blacks/African-Americans (19%) say their sleep is disturbed every night or almost every night by at least one of these concerns.
• Hispanics (16%) are more likely than Blacks/African-Americans (12%), Asians (9%) and Whites (7%) to say that health-related concerns have disturbed their sleep at least a few nights a week.

"So many people are suffering because of economic uncertainty," says Martica Hall, Ph.D., Associate Professor of Psychiatry at the University of Pittsburgh. "If you find yourself lying awake worrying, write a note to yourself to work on these issues the next day so you can dismiss those ideas at bed time. Consider using relaxation techniques and focus on calming activities and thoughts. If your problems persist, you may want to seek out a sleep professional."

Whites are the most likely to report sleeping with their pets and/or their significant other/spouse. Among those married or partnered, Whites are much more likely (14%) than the other ethnic groups (2% each) to say they usually sleep with a pet.

• Among those married or partnered, 90% of Whites report that they sleep with their significant other compared to 84% of Blacks/African-Americans, 76% of Hispanics and 67% of Asians.
• Interestingly, among all respondents, Whites are the least likely to say they sleep alone (21% versus 41% Blacks/African-Americans, 37% Asians and 31% Hispanics.)

Among those married or partnered respondents with children, Asians (28%) and Hispanics (22%) are the most likely to report that they sleep in the same room with their children (compared to 15% of Blacks/African-Americans and 8% of Whites).*

"Other studies support the findings that co-sleeping with children is prevalent with Asians," says Sonia Ancoli-Israel, Ph.D., chair of the National Sleep Foundation's Sleep in America Poll Task Force. "If you are having trouble sleeping, and you sleep with your spouse, your child, your pet or all three, remember that may be contributing to sleep disturbances that prevent you from getting a good night's sleep."

*Bed sharing/co-sleeping is a complex and controversial practice. This study did not specifically examine the issue of sleeping with infants, nor does the National Sleep Foundation wish to have these results misconstrued to suggest a position on the practice. Parental counseling about infant sleep environments is strongly suggested.

Sleep disorder diagnosis is uneven among the four ethnic groups.

The 2010 poll found that sleep disorders continue to be very common among the adults surveyed, with specific disorders occurring at different frequency among the four groups.

• Whites report the highest rate of diagnosis for insomnia (10%), and Blacks/African-Americans have the highest rate of diagnosed sleep apnea (14%) among the four groups.
• Among those experiencing sleep problems, Whites are the most likely to report using over-the-counter sleep aids at least a few nights a week (7%). Blacks/African-Americans are almost twice as likely to report taking medications prescribed by a doctor (7%) rather than over-the-counter sleep aids (3%). Asians are the least likely to report using any form of sleep medication (5%).

"If you are experiencing problems sleeping," says Balkin, "Take charge of your own sleep. You should critically examine your bedtime routines and pre-sleep activities and make time to ensure your bedroom is conducive to your sleep comfort. You will spend approximately a third of your life in bed, so it's worth it to take time to make sure your bed and bedtime routine are right for you. If you continue having problems sleeping for more than a few weeks, it's advisable to speak with your healthcare professional."

Ethnic groups seek help for sleep problems differently.

When experiencing a specific sleep problem, Blacks/African-Americans say they are more likely to speak with their doctor (16%) or research online (10%) than to get recommendations from friends or family (4%).

• Asians (15%) are the most likely to say they get advice from family and friends.
• Respondents were also asked if their healthcare professional or doctor had ever asked them about their sleep during a routine visit. At least four in ten Whites (48%), Blacks/African-Americans (42%) and Hispanics (40%) say yes; however, only 28% of Asians had been asked about sleep by their doctor.

"We are making progress with physicians and patients discussing sleep issues in regular office visits," says Cloud. "But we still have a lot of work to do to make sleep a routine part of every physician-patient interaction."

Adds David G. Davila, MD, Medical Director of the Baptist Health Sleep Center in Little Rock, Arkansas, "Sleep is a vital sign for overall health, therefore, discussing sleep problems should be an important part of health check ups for doctors and patients, especially since sleep disorders can affect many other medical conditions."