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Tuesday, February 27, 2024

Exposure to police violence linked to poor sleep in Black adults, study finds

Black adults who are exposed to news of police killings of unarmed Black people are more likely to suffer from poor sleep in the months to come than white adults, according to a study published Monday in the journal JAMA Internal Medicine

The new research highlights the insidious toll police violence takes on the Black community. 

Police killings not only affect victims and their families but can have “pernicious spillover effects” onto the public at large, said Dr. Atheendar Venkataramani, the lead study author and an associate professor of medical ethics and health policy at the University of Pennsylvania. 

The findings looked at survey results on sleep duration from 2013 through 2019 from two U.S. databases. The larger of the two, the Behavioral Risk Factor and Surveillance Survey, included responses from 181,865 Black and nearly 1.8 million white participants. The other, the American Time Use Survey, included data from 9,858 Black respondents and 46,532 white respondents. 

Even at baseline, Black participants were more likely to report getting less sleep than white participants. Forty-six percent reported getting less than 7 hours of sleep a night, deemed “short sleep,” compared to 33% of white participants, in the Behavioral Risk Factor and Surveillance Survey. Approximately 18% of Black respondents reported getting less than six hours of sleep a night, or “very short sleep,”  compared to 10% of white respondents. 

The researchers then looked at what happened to sleep after 331 police-involved killings of unarmed Black individuals. They found that Black people’s sleep worsened in the six months that followed a police killing, while white people saw no change in their sleep. 

The impact was greater for police killings that rose to national prominence, such as the killing of Eric Garner in New York in 2014. After such deaths, the study found, Black people reported a 4.6% increase in short sleep and an 11.4% increase in very short sleep, compared with the average. 

For all police killings, researchers saw an increase in shortened sleep among Black people living in the state where the killing took place. Reports of short sleep increased by 2.7% and reports of very short sleep increased by 6.5% in the six months after a police killing in those states, the study found.

The study points to dangers in society that other groups may not face and is a reminder that discrimination is a threat to “people’s health and livelihood,” Venkataramani said. 

“There are lots of reasons why Black Americans’ sleep — at least in terms of duration as well as quality — is worse than for potentially other groups,” he said. “Part of it has to do with some economic factors, the types of jobs people are in, the environments people are living in — with regards to the noise or crime or things that are around — and the experience of discrimination can also create stress, which is bad for sleep.” 

Lack of sleep is tied to a number of chronic health conditions, including heart disease, high blood pressure and risk of stroke, according to the National Heart, Lung and Blood Institute. It can also interfere with cognitive functions including learning, focusing and judging people’s emotions and reactions.

Chronic sleep deprivation caused by stress, racial trauma and other factors can increase Black Americans’ risk of developing anxiety, depression and post traumatic stress disorder, said Dr. Carmen Black, an assistant professor of psychiatry at Yale University. Black, who works with predominantly patients of color in her practice, said she uses self-validation for those who experience issues with sleep, especially if it results from structural racism. 

“It’s OK to feel this way because you’re responding to very real, very harmful things,” Black said she tells her patients. “The next thing I ask them is, ‘Would you even feel safe if I tried to put you back to sleep?’ because they’re often being reminded of neighborhood violence when they witness these murders. They’re often being reminded of structural safety concerns in their neighborhood.”

Self-validation is a tool also used by Christiana Awosan, a program director of marriage and family therapy at Iona University in New York. She said her clinic’s “phone was ringing nonstop” following George Floyd’s death in 2020 with calls from Black patients seeking help and wanting to talk about their racial trauma. 

Awosan said she also helps her patients focus on ways they can take care of themselves, including what they eat and drink, and even ways for them to affirm their Blackness. 

“Usually people know what they need to do to take care of themselves,” Awosan said. “It’s just that people are not given the space and that time to really think about those things and to intentionally do it.” 

Awosan suggests that patients unplug from their phone, television and other forms of media two to three hours before going to sleep. Meditation, reading, listening to calming music and praying are also methods her patients practice to help themselves fall asleep. Being “patient with your body” is also key, she added.

“I think sometimes, because we don’t understand what’s going on, then we’re, like, frustrated,” Awosan said. “Your body is responding to trauma. It makes sense that your body’s feeling this way.”

For Black’s patients who have trouble sleeping, she suggests avoiding taking naps during the day and consuming large amounts of caffeine. 

Still, experts agreed that these tactics don’t address the underlying problem of structural racism. The findings emphasize the need for evidence-based reforms to eliminate police killings of unarmed individuals in Black communities, the researchers wrote. 

“Society needs to pay attention to the way in which racial trauma really impacts the emotional, mental and physical well-being of Black people and any persons of color — any person that’s marginalized,” Awosan said. Medical professionals also need to assess and pay attention more to Black patients’ symptoms and the potential causes, she added. 

Black agrees, noting that “the answer to dismantling structural racism is dismantling structural racism,” she said.

“I believe that every physician should be an activist,” she added.

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