Single-arm pilot study of racial differences in sleep extension intervention outcomes among middle-aged adults at...

Sleep health disparities are well documented, whereas racial differences in treatment response to sleep interventions, are not. This single arm sleep intervention study explored treatment-response differences in sleep behaviors, quality of life, well-being, depressive symptoms, and daytime sleepiness between White and Underrepresented racial groups, as well as racial differences in pre-treatment sleep-relevant characteristics. Middle-aged adults at risk for the metabolic syndrome with short sleep duration (N = 41; 49% Underrepresented racial group [n = 20], 51% White [n = 21]) participated in a virtually-delivered, 12-week personalized systematic sleep time extension informed by cognitive behavioral therapy for insomnia. Sleep behaviors were estimated using wrist actigraphy. Quality of life, emotional well-being, daytime sleepiness, chronotype preference, daytime sleepiness, depressive symptoms, quality of life, and well-being were assessed using validated surveys. Sleep environment, race, and socio-demographic characteristics were self-reported. Underrepresented participants had a greater increase in fragmentation indexes and a greater improvement in emotional well-being from pre to post-intervention compared to their White counterparts of medium and medium-to-large magnitude, respectively. Within each racial group, statistically and clinically significant improvements in sleep duration and daytime sleepiness were found. Within the Underrepresented group, the sleep regularity index increased and sleep onset times advanced significantly. These exploratory findings suggest that future studies with larger samples should investigate the modulating effects of chronotype on sleep intervention treatment response for Underrepresented racial groups and the upstream contextual and systemic factors impacting sleep.Trial registration numberTrial registration number ClincalTrials.gov NCT03596983.