Link Between Poor Sleep and Psychological Distress Stronger in Minorities

Black woman sleeping in bed
Previous studies looking at the relationship between sleep and serious psychological distress (SPD) have generally lacked racial/ethnic diversity. In this study, the authors investigated associations between sleep and SPD among a large, nationally representative, and racially/ ethnically diverse sample.

The association between poor sleep health and depression and anxiety is stronger among racial/ethnic minorities according to a study published in the Nature of Science and Sleep.

Because previous studies that examine the association between sleep and serious psychological distress (depression, anxiety) lack diversity, researchers pooled a vast amount of data to explore the link in minorities. They looked at sleep duration, sleep disturbances, and symptoms of depression and anxiety.

Researchers collected data from the annual National Health Interview Survey (NHIS). Using survey data from 2004 to 2017, the researchers investigated adults who self-identified as non-Hispanic (NH)-White, NH-Black, and Hispanic/Latinx (n=79,367). Among the 316,840 participants, 3.6% exhibited serious psychological distress.

Among all groups, including Whites, the prevalence of current smoking was higher among participants with sleep and serious psychological distress (SPD) compared to those without SPD (40% vs 18%). Among Blacks, 39% of individuals with SPD smoked compared to those without SPD (19%). Among Hispanic/Latinx the ratio was 32% vs 14%.

The positive association between shortened sleep duration and SPD was strongest among Black participants. Positive associations between sleep disturbances and SPD were stronger among Black and Hispanic/Latinx adults compared to White adults.

The researchers also found “the strong association found between long sleep duration and SPD for Whites in our study is inconsistent with the literature that generally found associations between long sleep duration and SPD are strongest among racial/ethnic minorities, which warrants further investigation.”

Limitations include the fact that the cross-sectional design precludes causal inference: temporality between sleep and SPD cannot be established. In addition, all data were self-reported. Reports of SPD could be underestimated, while sleep duration is often overestimated.

“Understanding how environmental factors along with individual sociodemographic, behavioral, and clinical factors influence the effects of poor sleep on SPD will help identify populations at a higher risk of developing SPD,” the researchers concluded. “Such information can direct public health efforts towards both prevention and reduction of adverse mental health among vulnerable populations.”


Goldstein SJ, Gaston SA, McGrath JA, Jackson CL. Sleep health and serious psychological distress: A nationally representative study of the United States among White, Black, and Hispanic/Latinx adults. Nat Sci Sleep. 2020 Dec 2;12:1091-1104. doi:10.2147/NSS.S268087