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Black Americans are more likely to experience chronic insomnia than white Americans. This disparity may result from a lack of appropriate access to care, especially during the pandemic.

Moreover, the gap in insomnia prevalence may be widened by additional stress caused by the pandemic as Black Americans also experience higher rates of infection and poorer outcomes related to COVID-19 than white Americans. The structural mechanisms that drive these disparities have not been fully elucidated but may likely result from systemic inequities rather than genetic factors. 

This study, published in Sleep, was a follow-up study to the Sleep to Prevent Evolving Affecting Disorders (SPREAD) trial. It was conducted to assess the impact of the pandemic, stress related to COVID-19, and racial discrimination on insomnia. The study included 196 of the original 658 participants from the SPREAD trial, with 48 Black and 148 white participants. 

Ultimately, it was found that the odds of experiencing severe insomnia were approximately 4 times higher in Blacks than whites. An additional analysis showed that Black participants attributed their insomnia to the pandemic more often than white participants.

When evaluated for the impact of COVID-19, it was found that Black participants experienced more severe effects during the pandemic than white participants, such as disturbances to employment, a family member being diagnosed with COVID-19, and greater severity of disease in friends and family.

Finally, it was found that certain factors, like access to food, access to health care, and familial stress, indirectly accounted for almost 70% of the greater increases in severe insomnia in Black participants. 

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In conclusion, this study suggests that Black Americans have been disproportionately affected by the COVID-19 pandemic with severe disturbances to their sleep. Changes in structural inequities are needed to manage stress related to COVID-19 and improve insomnia in this population [1].


[1] Cheng, P., Casement, M. D., Cuellar, R., Johnson, D. A., Kalmbach, D., Cuamatzi Castelan, A., & Drake, C. L. (2021). Sleepless in COVID-19: racial disparities during the pandemic as a consequence of structural inequity. Sleep, 45(1). https://doi.org/10.1093/sleep/zsab242