Sleep and its Relationship to Racial and Ethnic Disparities in Cardiovascular Disease

There are substantial racial/ethnic disparities in cardiovascular disease in the U.S., but few mechanisms have emerged as feasible intervention targets. A growing body of research suggests that racial/ethnic differences in sleep deficiency, including extreme sleep duration, sleep-disordered breathing, and insomnia, may help explain disparities in cardiovascular disease. However, little is known about the mechanisms underlying racial/ethnic disparities in sleep. In this article, we review the extant literature on sleep and cardiovascular outcomes (eg, hypertension, stroke, cardiovascular disease) and racial/ethnic differences in these relations. We also discuss possible mechanisms that might help explain racial/ethnic sleep disparities, including neighborhood disadvantage, psychosocial and occupational stressors, acculturation, and treatment access and adherence. More research is needed to establish causal linkages among race/ethnicity, sleep, and these mechanisms, but existing evidence suggests that targeting these factors in interventions may reduce racial/ethnic sleep disparities and improve primary prevention of cardiovascular disease among all racial/ethnic groups.