The National Sleep Foundation’s annual survey says African Americans get the least amount of sleep of any ethnic group, and the ability to change some of the causes of our sleep deprivation are within our control, if we make adjustments (sleep Hygiene).
At the same time, there also exist psycho-social stressors such as unemployment, poverty, and racism which we are unable to control.
Animals and Humans
“The only way to understand sleep is to study animals,” says Jeromme Siegel, Ph.D., professor of psychiatry at the UCLA Center for Sleep Research. “If we could better understand animal sleep, we would better understand the core aspects of sleep.”
Sleep is a necessity, if a living organism is to survive and continue its species, says one of the basic laws of biology (continuation of species). Some organisms only require an average sleep time of 1.9 hours such as the giraffe or have the capability of sleeping decades, such as the minuscule 1.5 mm Tardigrade water bear with its eight legs. The Tardigrade can undergo a process called cryptobiosis, which enables it to sleep for decades; this allows the small animal to survive in hostile environments such as droughts. When Dolphins sleep, they float to the surface to exhale. There are also animals that sleep with one eye open to sense a predator before it strikes.
When we look at the human species, our sleeping habits may not be as diverse as the animals we share the planet with, but there are ethnic differences that might account for many things, according to a recent report by scientists involved in the study of sleep.
A peek inside the African American bedroom
When we think of sleep, we may have thoughts of laying down and eventually dosing off hopefully for at least eight full hours of shut eye. But if you are African American, a full night sleep is a rarity, according to the National Sleep Foundation and several universities participating in the March 2010 Sleep in America study. In addition to not getting enough sleep African Americans, also suffer from Parasomnia (disrupted sleep related-related event) also known as sleep paralysis (SP) at a higher level than any other ethnicity. Increased levels of psycho-social stressors, including poverty, racism, acculturation, genetic make up, and diet may contribute to higher rates of SP in Blacks.
The witch is holding down my chest (Sleep Paralysis)
There was no mention of sleep paralysis in the report, but it is a sleep disorder that has a very high occurrence within the African American community. Sleep paralysis (SP) is an altered state of consciousness experienced when falling asleep or awakening. Individuals experience paralysis and often feel a weight or pressure on their chest during episodes, and the duration typically ranges from a few seconds to a few minutes. People may experience vivid, frightening hypnogogic (hallucinations when falling asleep) or hynopompic (hallucinations when awakening) hallucinations (Hall, 1993; Ness, 1978). Individuals may also report experiencing panic-like symptoms such as rapid heartbeat, shortness of breath, fear and intense emotional distress.
Some researchers name the experience Isolated Sleep Paralysis (ISP), whereas others use the term ISP only for SP that is not associated with any medical or psychiatric disorder (Bell et al., 1984; Fukuda, Miyasita, Inugami, & Ishihara, 1987; Ohayon, Zulley, Guilleminault, & Smirne, 1999; Paradis, Friedman, Hatch, 1997).
African Americans are more susceptible to sleep paralysis and experience a much higher occurrence of the phenomenon, according to Dr. Vanessa Enku at Howard University’s Sleep Disorder Center. She said most clinicians believe Blacks experience this as a result of our diet and genetic make up and the stress that we may experience. It can also be caused by other factors such as sleeping face upwards (supine position).
Our Weekly conducted an informal poll and found that out of 140 African Americans questioned in Leimert Park, 90 of the individuals remembered experiencing sleep paralysis, 13 has direct knowledge of a family member or spouse who has experienced SP, 3 were not sure and, 34 have not experienced it.
Nelson Miller, a 51-year-old African American believes he has experienced sleep paralysis at least five times in his life; he said “it felt like some one was holding him down. You are not able to talk or move; it was horrible. It felt like someone was riding me, I thought I was near death.”
He remembers having a conversation with his grandmother following his first or second experience, while in grade school, and she told him a witch was riding him and instructed the horrified kid to place a broom outside his door.
When we look at sleep paralysis and different cultures, researchers found that most African American folklore associates the event with the idea of a witch riding your chest or sitting on you.
In the Middle East, it has been associated with evil jinns or demons, and in Mexico the spirit of a dead person is laying on top of you.
Miller remembers a college professor associating sleep paralysis with a build up of lactic acid in the body. He wasn’t sure if the information was accurate, however he felt it aided how he coped with his last episode about 20 years ago. Reminiscing about his last experience, he feels hearing about lactic acid allowed him to understand what was going on and not struggle, since he felt he understood chemically what was happening to his body during the episode. A lactic acid build up creates a sensation of your leg falling asleep and not sleep paralysis, however the incorrect association of lactic acid and sleep paralysis may have acted as a form of placebo allowing the person experiencing paralysis not to struggle; the more you struggle to move the more intense the increased heart-rate, and the inability to scream becomes.
Thomas J. Balkin, Ph.D., chairman of the National Sleep Foundation, thinks African Americans should improve their sleep hygiene, which is the process of preparing for sleep. According to Balkin, this consists of having a set time schedule to get into bed and wake up (without an alarm clock which, allows a smooth transition from deep sleep and enables us to use our circadian rhythm (biological clock); make sure the bedroom is dark and clean, avoid caffeine, nicotine, and alcohol after 2 p.m., do not perform stressful tasks right before bed, exercise on a regular basis, but complete your workout three hours before bed, and use the bedroom only for sleep and sex.
African Americans have the most active sleep hygiene and improving it would involve curtailing the following–75 percent of us watch television from bed as opposed to viewing it in another room, 71 percent of us pray prior to going to bed or conduct some type of religious practice. African Americans and Hispanics (10 percent each) are 10 times more likely to report having sex every night as compared to Asians (1 percent) and 2.5 times more likely than Whites to do so (4 percent). African Americans usually conduct job-related work an hour before bed time. African Americans and Hispanics also lose sleep every night thinking about finances and employment unlike Asians and Whites.
In addition to advising people to improve sleep hygiene, sleep specialists should realize that most of the diseases that African Americans suffer from are directly impacted by the lack of sleep including diabetes and heart disease. They should relay this message to their patients.
The first sleep clinics were opened in the 1970’s to study sleep science and enhance the ability to sleep. The focus of most of these studies did not take into consideration the genetic make up of African Americans or social issues. Three years ago Howard University School of Medicine opened its Sleep Center focusing on the science of African American sleep and the issues of insomnia in the Black community that can directly that impact heart disease and diabetes. The funding of African American sleep studies are very rare, so hopefully teaching hospitals such as Howard University’s sleep center will allow the scientific community to focus on the unanswered questions of African American sleeping disorders (Apnea), questions surrounding Sleep Disordered Breathing, and our different maxilla-mandibular structure.
The 2010 Sleep in America Poll
The National Sleep Foundation (NSF), the Sleep in America Poll questioned more than 1,000 people, almost evenly divided among the different ethnic groups. The results were released as part of its 13th NSF’s annual National Sleep Awareness Week® campaign, held in March just before the switch to Daylight Savings Time.
Among the findings were the
* Blacks/African Americans report getting the least amount of sleep on workdays/weekdays (6 hours and 14 minutes). Interestingly, they also say that they need only seven hours and five minutes of sleep each night to perform at their best during the day, which is significantly less sleep than Asians and Hispanics (7 hours and 29 minutes each).
* Blacks/African Americans report getting an average of 34 minutes less sleep on a work night/weeknight than Asians and 38 minutes less than Whites.
“The finding that Blacks/African Americans say they need less sleep and get less sleep is instructive for public health professionals,” says Jose S. Loredo, MD, MPH, Professor of Medicine at the University of California, San Diego. “Their total sleep time and attitudes regarding sleep may be associated with Blacks/African Americans’ higher rates of sleep apnea, hypertension and diabetes and provide sleep-related insight into how to improve awareness and education programs and, very importantly, how to improve therapy compliance rates.”
* Blacks/African Americans report the busiest bedtime routines.
* Blacks/African Americans are the most likely to report performing activities in the hour before going to bed every night or almost every night, specifically watching TV (75%) and/or praying or doing another religious practices (71%).
* Whether on weekdays/workdays or non-workdays/weekends, Blacks/African Americans spend much more time in bed without sleeping than the other ethnic groups (54 minutes on weekdays/workdays and 71 minutes on non-workdays/weekends).
* Blacks/African Americans and Hispanics (10% each) are ten times more likely to report having sex every night than Asians (1%) and 2.5 times more likely than Whites (4%).
* Most Blacks/African Americans report praying every night (71%); more than four times the reported frequency of Asians (18%), twice the rate of Whites (32%) and 1.5 times the rate of Hispanics (45%).
* Among those employed, Blacks/African Americans (17%) and Asians (16%) are more likely than Whites (9%) and Hispanics (13%) to report doing job-related work in the hour before bed.
* Blacks/African Americans report losing sleep every night over personal financial concerns (12%) and employment concerns (10%) at a higher rate than Whites (6% and 7%) or Asians (1% and 4%).
* Hispanics are almost equally concerned each night about these two issues (11% and 9%, respectively).
* Asians report getting the best sleep, and having the least amount of sleep problems and infrequent use of sleep aids.
* Asians are the ethnic group (84%) most likely to say that they had a good night’s sleep at least a few nights or more a week. In addition, Asians are about half as likely (14%) to discuss their sleep issues with a health care professional, and are half as likely (10%) to report having been diagnosed with a sleep disorder.
* Asians are the least likely to report using sleep medication at least a few nights a week (5% versus 13% Whites, 9% Blacks/African Americans and 8% Hispanics).
* Asians are the least likely (9%) to say that they “rarely” or “never” have a good night’s sleep, compared with 20% of Whites, 18% of Blacks/African Americans and 14% of Hispanics.
* The poll shows that Asians are more than twice as likely to use the Internet every night in comparison to any other group (51% versus 22% Whites, 20% Blacks/African Americans, 20% Hispanics). They are also the least likely to watch TV an hour before sleep (52% versus 64% Whites, 72% Hispanics and 75% Blacks/African Americans).
* Asians report the use of herbal and alternative therapies at rates similar to Hispanics (2% each), but less than Whites (4%).
* While Blacks/African Americans report the least amount of sleep, they also say they need less sleep.
* Hispanics are the most likely to say they are kept awake by financial, employment, personal relationship and/or health-related concerns.
* Overall, at least one-third of Hispanics (38%) and Blacks/African Americans (33%) report that any of these concerns disturb their sleep at least a few nights a week, compared to about one-fourth of Whites (28%) and/or Asians (25%).
* Moreover, about 2 in 10 Hispanics (19%) and Blacks/African Americans (19%) say their sleep is disturbed every night or almost every night by at least one of these concerns.
* Hispanics (16%) are more likely than Blacks/African Americans (12%), Asians (9%) and Whites (7%) to say that health-related concerns have disturbed their sleep at least a few nights a week.
* Whites are the most likely to report sleeping with their pets and/or their significant other/spouse.
* Whites report the highest rate of diagnosis for insomnia (10%), and Blacks/African Americans have the highest rate of diagnosed sleep apnea (14%) among the four groups.
* Among those experiencing sleep problems, Whites are the most likely to report using over-the-counter sleep aids at least a few nights a week (7%). Blacks/African Americans are almost twice as likely to report taking medications prescribed by a doctor (7%) rather than over-the-counter sleep aids (3%). Asians are the least likely to report using any form of sleep medication (5%).