Sleep as an Essential Luxury: Disparities in Access to a Vital Physiological Process

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2021-05

Authors

Zhou, Jina

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Abstract

The ultimate goal of this paper is to illustrate and explain the necessity for recognizing disparities in access to sleep that exist based on race and socioeconomic status in the United States.

The first section of the paper will focus on contextualizing the problem of sleep disparities through an overview of sleep science and current research on sleep disparities that exist between different socioeconomic and racial/ethnic groups, ultimately aiming to answer the question of “where are we now?” in terms of sleep science and sleep inequity. Here, I will summarize what is currently known about the physiology of sleep, sleep related disorders, and racial, ethnic, and socioeconomic-mediated differential outcomes in sleep health based on current scientific and medical literature. Of note here is the relatively short history of existing sleep disparities research, which in itself may be an indication of the inequities that exist in sleep and sleep medicine.

The second section will aim to summarize the history of sleep, along with the development of sleep deprivation and sleep disparities, ultimately aiming to answer the question of“how did we get here?” by identifying the emergence of inequity in sleep, alongside trends that led to the commoditization of sleep. This section will begin by chronologically tracing depictions of sleep behaviors and sleeping conditions through history, starting with a broad survey of ancient societies from different areas of the world. The research will then follow the historical development of sleep disparities between different socioeconomic classes in Medieval Western societies, the most well-documented of which being England and similar Western European countries. The remainder of the historical research will focus on framing an unequal culture of sleep deprivation that primarily arose following the Industrial Revolution.

The final section of this paper will consist of a discussion in which the information from the previous two sections is taken into consideration in proposing recommendations and hypotheses for the future development of sleep research and policies affecting or affected by sleep. This part of the paper will primarily emphasize that sleep is a key health determinant that is significantly impacted by structural inequalities disproportionately affecting certain groups of people, and that both scientific research and policymaking must recognize this in order to enact real change that results in better sleep for the majority in the United States.

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