Race/ethnic differences in educational gradients in sleep duration and quality among U.S. adults

At the population level, those with more education tend to report better sleep, mirroring the education gradient found in other health outcomes. But research has shown that higher educational attainment does not always confer the same health benefits for Non-Hispanic Black (Black) and Hispanic adults as it does for Non-Hispanic White (White) adults. It is therefore possible that the educational gradient in sleep varies across racial/ethnic groups in the United States. Using the 2004-2018 National Health Interview Survey (N = 356,048), we examined differences in self-reported sleep duration and sleep quality by level of educational attainment and race/ethnicity. Utilizing multinomial (sleep duration) and negative binomial (times in the past week with difficulty falling asleep and staying asleep) regression models, we found that, compared to their less educated counterparts, college or more educated Whites were more likely to report ideal sleep compared to short or long sleep, and also reported fewer times with difficulty falling or staying asleep. The education-sleep association was generally reversed for Black and Hispanic adults, with the worst sleep being reported by those with college-level education. These patterns remained after adjusting for health behaviors, health outcomes, and socioeconomic status. Our study suggests that education does not yield the same protective benefit for sleep among Black and Hispanic adults as it does for White adults, and that highly educated Black and Hispanic adults in particular experience a sleep disadvantage. The differential education gradient in sleep may, therefore, be an important factor underlying current racial and ethnic health disparities.