Regular blog readers will know I am a big fan of the benefits of sleep. Not only have I blogged extensively about the topic and advocate for the benefits of sleep with my students through lessons that often lead to the creation of sleep-related advocacy podcasts, but I am also a fan of sleep myself. I can often be heard sharing that ‘sleep is my superpower.’ That said, the theme of 2024’s World Sleep Day: “Sleep Equity for Global Health” got me questioning whether my teaching of sleep, much like my personal sleep habits, could benefit from going deeper.

Typically, my teaching of sleep covers the benefits of sleep in terms of performance (from academics to the stage to the sports arena and beyond), what happens when we don’t prioritize sleep, and then we analyze the influences on our personal sleep behaviors. The student takeaway from these lessons is a greater understanding of sleep hygiene, culminating in a goal to improve their own sleep through simple actions which might include considering darker, cooler rooms, reducing late screen time and caffeine consumption, embracing meditative practices, and experimenting with aromatherapy. While these actions can potentially improve sleep quality for many, they ignore the fact that there are individuals for whom quality sleep remains out of reach due to the context in which they find themselves.

As a young teacher living in London, I lived in a housing situation that wasn’t conducive to quality sleep. The windows in my bedroom were old and didn’t entirely fit the frame. Two doors down from me was a social club that operated late at night, releasing their inebriated customers in the early morning hours. There was a street lamp DIRECTLY outside my bedroom window, and my house was on a busy road with a public bus stop on the corner. Noise, temperature, and light pollution (plus possibly dampness and mold) all impacted my sleep quality, and no amount of meditation and lavender essential oils would rectify that situation. It wasn’t that I was making poor choices regarding my sleep hygiene; it was the social and economic conditions that I found myself in that impacted my sleep.

The factors that lead to health disparities, including sleep health, are what public health experts call the Social Determinants of Health—the conditions in which people are born, live, learn, work, and play. Think neighborhood noise and light pollution, housing instability, shift work, chronic stress, and barriers to healthcare access. These factors are not distributed equally, and they disproportionately affect communities of color, contributing to persistent gaps in health outcomes.

Recent research from Yale shows that Black Americans are consistently less likely to get the recommended amount of sleep—and those disparities have widened over time. In 2018, the percentage of Black people reporting short sleep was 11 points higher than white people. That gap was 7.5 points in 2004. The difference is especially stark for Black women and for those with middle or high incomes.

This isn’t just about sleep hygiene. It’s about systems.

Dr. Dayna Johnson, a leading sleep researcher, puts it plainly:

The root cause of sleep and health disparities overall is racism.

SHAPE America’s new National Health Education Standards explicitly call on us to teach through the lens of equity, justice, and the social determinants of health. That means asking students to reflect on their habits or build a sleep routine is not enough. We must explore why some people can make those changes more easily—and why others face systemic barriers just to rest. This allows us to take our ‘Analyzing Influences” conversations deeper and can make our ‘Advocacy’ efforts more impactful.

So when I tell my students that sleep is essential for health, I also need to say this:
‘Sleep is not equally accessible’. And my teaching about it has to reflect that.

It’s time to expand our sleep lessons by asking:

• Who has the time, space, and support to sleep well?
• Who doesn’t—and why?
• How can health education build understanding, empathy, and advocacy?

These questions are the heart of meaningful health education. If I want my students to understand their own health—and the health of others—I can’t ignore the forces that shape it.

There’s still time to deepen the lesson.

References:

Johnson, D. (2023). Racism and Sleep: How Race-Based Injustices Impact Sleep Health. Project Sleep. Retrieved from https://project-sleep.com/black-history-month-2023-racism-and-sleep/

Johnson, D. A., Jackson, C. L., Williams, N. J., & Alcántara, C. (2021). Are sleep patterns influenced by race/ethnicity – A marker of structural racism? Journal of Clinical Sleep Medicine, 17(2), 301–302. https://doi.org/10.5664/jcsm.10072

This microblog post was a featured post in #slowchathealth’s #microblogmonth event. You can search for all of the featured posts here. Please do follow each of the outstanding contributors on social media (including Andy Milne, the author of this post) and consider writing a microblog post of your own to be shared with the global audience of slowchathealth.com

Pair this blog post with the following:

Sleeping While Queer via Project Sleep

“The Space Between”: Identifying Barriers to Inclusion for Students with Disabilities by Jen Heebink

Physical Literacy, Inclusiveness, and The Spatial Imaginary: A Summer Challenge by Dr. Brian Culp

Starting a Purposeful Practice of EDI by Allisha Blanchette

Sign up for The Health Divide newsletter from Center For Health Journalism offering fresh takes and news updates on health equity and disparities.

Have you read the latest Book of the Month recommendation?