Last updated on February 1st, 2024 at 12:06 pm
A good night’s rest does more than energize you—sleep can affect your mood, keep your heart healthy, and help you feel better when you’re sick. But not everyone gets enough sleep every night to feel rested. In fact, about 1 in 3 adults in the United States say they don’t get enough sleep. At the same time, racial and ethnic minorities and people with lower incomes are most likely to be sleep deprived.
These groups are also more likely to live in segregated neighborhoods or unsafe housing. They are less likely to have access to health care, healthy food, green space, or places to exercise. They are also more likely to live near environmental hazards and experience discrimination. These factors are called social determinants of health (SDOH).
SDOH can cause a lot of stress, and stress makes it harder to get enough sleep. That’s why researchers are looking at SDOH more closely to help people get better sleep.
Marishka K. Brown, Ph.D., Director of the National Center on Sleep Disorders Research (NCSDR), said that people of different racial or ethnic backgrounds of the same socioeconomic status tend to have similar health. But when their living environments change, their health often changes, too. In other words, it’s about place…not race.
“For the longest time, a lot of research focus was on the biology…on the individual,” said Dr. Brown. “We know that’s important; we know those factors contribute to health. We know genetics matter … but it’s not the biggest piece.”
Noisy neighbors and poor air quality can keep you awake
One way to get enough sleep is to keep bedrooms as dark and quiet as possible. But in urban areas, it may be hard to keep bedrooms completely dark. This can be due to things like streetlights outside or motion-sensor lights for safety reasons. Surrounding noise from the street or neighbors close by can also make it hard to fall and stay asleep.
Another is to keep bedrooms cool, but this can be a problem, too. Big cities can turn into “heat islands” and become hotter than surrounding towns. That’s due to less tree cover and more pavement or buildings that absorb heat.
“One of the things your body does naturally for sleep is cool itself down,” Dr. Brown said. “But if you are in a space that is 10 or 15 degrees hotter than the surrounding population in the suburbs…those populations are disadvantaged.”
Air quality is also a concern for sleep health because it can cause breathing problems. In urban areas, air pollution can worsen respiratory problems such as asthma, especially in children.
Black children are also four to six times more likely to have sleep-disordered breathing problems than White children. But this is not due to genetics—it’s tied to living in households with lower incomes and in more environmentally hazardous communities.
Irregular schedules hinder wellness
Sticking to a bedtime routine or sleep schedule is a great way to get enough shut eye every night, but this may not be possible for people who work irregular hours. Shift workers, emergency personnel, health care professionals, or truck drivers are some people who do not always work a regular 9 a.m. to 5 p.m. schedule.
Getting enough quality sleep can also be hard for people who work nights. Your body’s circadian rhythm (a series of physical, mental, and behavioral changes in your body that follow a 24-hour cycle) is very sensitive to light. Staying awake at night and sleeping during the day can disturb your circadian rhythm. This can cause other biological processes, such as your immune system, to not perform well.
Over time, irregular sleep can lead to diabetes, heart disease, high cholesterol, and obesity. The National Heart, Lung, and Blood Institute (NHLBI) studied irregular sleep patterns in a group of about 2,000 people ages 45 to 84 and followed them five years. People with irregular sleep patterns were more than twice as likely to develop cardiovascular disease compared to those with regular sleep patterns. This was even more common among racial and ethnic minorities.
Getting help for sleep problems is not always easy
Access to health care is important for sleep health and wellness in general. Treating underlying conditions may be necessary to get better sleep. For example, if you are not sleeping well, your health care provider may suggest doing a sleep study with a specialist to see if you have a sleep disorder such as sleep apnea or narcolepsy.
But for people without health insurance or living in rural areas, seeing a specialist may not be an option.
“Someone in the middle of Iowa who doesn’t have a large academic center anywhere near them is going to have serious challenges with seeing a specialized provider,” Dr. Brown said. “Remote options such as telehealth could begin to break down some of those barriers, but currently they still exist.”
Interest in sleep health research—and in finding solutions to eliminate health disparities—is growing. NCSDR, National Institute on Minority Health and Health Disparities, and other institutes across NIH are coming together to find connections between sleep and community health.
“It is so enlightening to see the focus on sleep disparities, particularly in the context of social determinants of health,” Dr. Brown said.
Urefu wa usiku mzuri hufanya zaidi ya kukupa nishati - usingizi unaweza kuathiri hali yako ya moyo, kuweka moyo wako afya, na kukusaidia kujisikia vizuri wakati unakuwa mgonjwa. Lakini si kila mtu anayelala usingizi wa kutosha kila usiku ili ahisi amepumzika. Kwa kweli, karibu mtu mmoja kati ya watu wazima watatu nchini Marekani anasema kwamba hawapi usingizi wa kutosha. Wakati huohuo, watu wa jamii ndogo-ndogo na wenye mapato ya chini wana uwezekano mkubwa zaidi wa kukosa usingizi. Vikundi hivyo pia huishi katika maeneo yaliyogawanyika au katika nyumba zisizo salama. Hawana uwezekano mkubwa wa kupata huduma za afya, chakula chenye afya, maeneo ya kijani kibichi, au mahali pa kufanya mazoezi. Pia ni uwezekano mkubwa zaidi wa kuishi karibu na hatari za mazingira na kupata ubaguzi. Sababu hizi huitwa sababu za kijamii za afya (SDOH). SDH inaweza kusababisha mkazo mkubwa, na mkazo hufanya iwe vigumu kupata usingizi wa kutosha. Hiyo ndiyo sababu watafiti wanaangalia SDOH kwa karibu zaidi ili kuwasaidia watu kupata usingizi bora. "Mariska K. Brown, Mkurugenzi wa Kituo cha Kitaifa cha Utafiti wa Matatizo ya Kulala, alisema: ""Watu wa asili tofauti za kikabila au kikabila wana hali sawa ya kijamii na kiuchumi huwa na afya sawa." Lakini mazingira yao yanapobadilika, mara nyingi afya yao hubadilika pia. Kwa maneno mengine, ni kuhusu mahali...si jamii. "Kwa muda mrefu zaidi, utafiti mwingi ulikazia biolojia... ya mtu binafsi", alisema Dakt. Brown. <unk>Tunajua kwamba <unk>ni muhimu; tunajua mambo hayo huchangia afya. Tunajua kwamba chembe za urithi ni muhimu, lakini si sehemu kubwa zaidi. Majirani wenye kelele na hali mbaya ya hewa inaweza kukufanya usingize. Njia moja ya kupata usingizi wa kutosha ni kuweka vyumba vya kulala vikiwa vime giza na kimya iwezekanavyo. Lakini katika maeneo ya mijini, huenda ikawa vigumu kuweka vyumba vya kulala vikiwa vime giza kabisa. Hii inaweza kuwa kutokana na mambo kama vile taa za mitaani nje au taa za sensor ya mwendo kwa sababu za usalama. Sauti kutoka barabarani au kutoka kwa majirani karibu pia inaweza kufanya iwe vigumu kuanguka na kulala. Njia nyingine ni kuweka vyumba vya kulala vyenye baridi, lakini hilo pia laweza kuwa tatizo. Majiji makubwa yanaweza kugeuka kuwa "visiwa vya joto" na kuwa moto zaidi kuliko miji iliyo karibu. Hiyo ni kwa sababu ya chini ya miti na zaidi pavement au majengo ambayo kunyonya joto. "Mojawapo ya mambo ambayo mwili wako hufanya kwa kawaida ili kulala ni kujipunguza joto", akasema Dakt. Brown. "Lakini ikiwa uko katika nafasi ambayo ni joto la digrii 10 au 15 kuliko idadi ya watu walio karibu katika vitongoji... idadi hiyo ya watu ni hasara. ""Ubora wa hewa pia ni wasiwasi kwa afya ya usingizi kwa sababu inaweza kusababisha matatizo ya kupumua." Katika maeneo ya mijini, uchafuzi wa hewa waweza kuharibu matatizo ya kupumua kama vile pumu, hasa kwa watoto. Watoto weusi pia wana uwezekano wa mara nne hadi sita zaidi ya kuwa na matatizo ya kupumua ya usingizi kuliko watoto weupe. Lakini hii si kwa sababu ya maumbile - ni kushikamana na kuishi katika kaya na mapato ya chini na katika jamii zaidi hatari kwa mazingira. Kufuata ratiba ya kulala ni njia nzuri ya kupata macho ya kutosha kila usiku, lakini hii haiwezi kuwa rahisi kwa watu wanaofanya kazi kwa masaa yasiyo ya kawaida. Wafanyakazi wa zamu, wafanyakazi wa dharura, wataalamu wa huduma za afya, au madereva wa malori ni baadhi ya watu ambao si daima kufanya kazi ya kawaida 9 a.m. - 5 p.m. ratiba. Kupata usingizi wa kutosha wa hali ya juu pia kunaweza kuwa vigumu kwa watu wanaofanya kazi usiku. Mzunguko wa mwili wako wa circadian (mfululizo wa mabadiliko ya kimwili, kiakili, na tabia katika mwili wako ambayo hufuata mzunguko wa masaa 24) ni nyeti sana kwa nuru. Kukaa usingizi usiku na kulala mchana kunaweza kuharibu utaratibu wako wa mzunguko wa saa. Hii inaweza kusababisha michakato mingine ya kibiolojia, kama vile mfumo wako wa kinga, usifanye vizuri. Baada ya muda, usingizi usio wa kawaida waweza kusababisha kisukari, magonjwa ya moyo, kolesteroli ya juu, na unene kupita kiasi. Taasisi ya Kitaifa ya Moyo, Mapafu na Damu (NHLBI) ilichunguza tabia za usingizi zisizo za kawaida katika kikundi cha watu 2,000 wenye umri wa miaka 45 hadi 84 na kuwafuatilia kwa miaka mitano. Watu wenye tabia isiyo ya kawaida ya kulala walikuwa na uwezekano mkubwa wa kupata ugonjwa wa moyo na mishipa ya damu kuliko wale wenye tabia ya kulala ya kawaida. Jambo hilo lilitukia zaidi miongoni mwa watu wa jamii ndogo-ndogo. Kupata msaada kwa matatizo ya usingizi sio rahisi kila wakati, na upatikanaji wa huduma za afya ni muhimu kwa afya ya usingizi na afya kwa ujumla. Huenda ikawa lazima kutibu magonjwa ya msingi ili usingizi uwe bora. Kwa mfano, ikiwa unalala vibaya, daktari wako anaweza kupendekeza kufanya uchunguzi wa usingizi na mtaalamu ili kuona kama una ugonjwa wa usingizi kama vile apnea ya usingizi au narcolepsy. Lakini kwa watu wasio na bima ya afya au wanaoishi katika maeneo ya vijijini, huenda ikawa vigumu kumwona mtaalamu. "Mtu katikati ya Iowa ambaye hana kituo kikubwa cha kitaaluma karibu nao atakuwa na changamoto kubwa za kuona mtoa huduma maalumu", alisema Dk Brown. <unk>Chaguzi za mbali kama vile telehealth zinaweza kuanza kuvunja baadhi ya vizuizi hivyo, lakini kwa sasa bado zipo.<unk> Maslahi katika utafiti wa afya ya usingizi <unk>na katika kupata suluhisho za kuondoa tofauti za afya <unk>inazidi. NCSDR, Taasisi ya Kitaifa ya Afya ya Wachache na Tofauti za Afya, na taasisi zingine katika NIH zinakusanyika pamoja kupata uhusiano kati ya usingizi na afya ya jamii. "Ni jambo la kuelimisha sana kuona mwelekeo wa kutofautiana kwa usingizi, hasa katika muktadha wa mambo ya kijamii yanayoamua afya", alisema Dakt. Brown.