Racial/ethnic disparities in sleep duration and sleep disturbances among pregnant and non-pregnant women in the United States

Lydia Feinstein, Ketrell L. McWhorter, Symielle A. Gaston, Wendy M. Troxel, Katherine M. Sharkey, Chandra L. Jackson

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


Sleep disturbances among pregnant women are increasingly linked to suboptimal maternal/birth outcomes. Few studies in the USA investigating sleep by pregnancy status have included racially/ethnically diverse populations, despite worsening disparities in adverse birth outcomes. Using a nationally representative sample of 71,644 (2,349 pregnant) women from the National Health Interview Survey (2004–2017), we investigated relationships between self-reported pregnancy and six sleep characteristics stratified by race/ethnicity. We also examined associations between race/ethnicity and sleep stratified by pregnancy status. We used average marginal predictions from fitted logistic regression models to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs) for each sleep dimension, adjusting for sociodemographic and health characteristics. Pregnant women were less likely than non-pregnant women to report short sleep (PROverall = 0.75; 95% CI, 0.68–0.82) and more likely to report long sleep (PROverall = 2.06; 95% CI, 1.74–2.43) and trouble staying asleep (PROverall = 1.34; 95% CI, 1.25–1.44). The association between pregnancy and sleep duration was less pronounced among women aged 35–49 years compared to those <35 years. Among white women, sleep medication use was less prevalent among pregnant compared to non-pregnant women (PRWhite = 0.45; 95% CI, 0.31–0.64), but this association was not observed among black women (PRBlack = 0.98; 95% CI, 0.46–2.09) and was less pronounced among Hispanic/Latina women (PRHispanic/Latina = 0.82; 95% CI, 0.38–1.77). Compared to pregnant white women, pregnant black women had a higher short sleep prevalence (PRBlack = 1.35; 95% CI, 1.08–1.67). Given disparities in maternal/birth outcomes and sleep, expectant mothers (particularly racial/ethnic minorities) may need screening followed by treatment for sleep disturbances. Our findings should be interpreted in the historical and sociocultural context of the USA.

Original languageEnglish
Article numbere13000
JournalJournal of Sleep Research
Issue number5
StatePublished - Oct 1 2020

Bibliographical note

Publisher Copyright:
© 2020 European Sleep Research Society


  • ethnic groups
  • pregnancy
  • race factors
  • sleep
  • sleep deprivation
  • sleep initiation and maintenance disorders

ASJC Scopus subject areas

  • Cognitive Neuroscience
  • Behavioral Neuroscience


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