Sleep Health
Background
Getting enough sleep is not a luxury—it is something people need to reach their highest attainable level of health. It is recommended that adults get 7 or more hours of sleep per night and children, depending on their age, get between 8-16 hours each day. One in three US adults report that they get less that the recommend amount of sleep.
An estimated 50 to 70 million Americans chronically suffer from a disorder of sleep and wakefulness, hindering daily functioning and adversely affecting health and longevity. The cumulative long-term effects of sleep deprivation and sleep disorders have been associated with a wide range of negative health consequences including an increased risk of hypertension, diabetes, obesity, depression, heart attack, and stroke. In the short-term, not getting enough sleep can also result in motor vehicle crashes and mistakes at work that can result in machine-related injuries and disability [1].
The DC Healthy People 2020 goals are that:
1. The public is knowledgeable about how adequate sleep and treatment of sleep disorders improve health, productivity, wellness, quality of life, and safety on roads, at home, and in the workplace.
2. Sleep deprivation is rare and sleep disorders appropriately treated.
3. Environments support healthy sleep for infants, children, and families.
Adults
Sleep deprivation can be caused by many factors including stress, excessive noise or light from using technology late at night, the need to work multiple jobs to afford basic needs, or physical factors such as diet or exercise. Some medical conditions, medications, and sleep disorders like sleep apnea also affect how long and how well you sleep.
About 60% of District adults reported they got sufficient sleep in the past month [2]. The prevalence of sufficient sleep varies by sex, race/ethnicity, age, sexual orientation, and even geography. Increased public education and greater awareness of the burden of sleep loss and sleep disorders as well as scientific advances have poised the field of sleep medicine for great strides.
However, advances will require an organized strategy to increase and coordinate efforts in training and educating the public, researchers, and clinicians, as well as improved infrastructure and funding for this endeavor [1]. Without sleep health education, individuals often prioritize other activities over sleep and accept constant sleepiness and sleep disruption as inevitable parts of life.
…I think there is just a lot of being poor, and being a person of color, in this country, for sure in this city…all that stress… your mental health is not as good and as clear as it should be. So that’s the stress of poverty, the stress of racism causes you all this…really its trauma, it’s PTSD…you can’t get a good night sleep cause you’re always being a little hyper-vigilant because you’re worried about what’s next. What’s going to happen next to me? And if you don’t sleep…we know it has immediate effect on the blood pressure, which leads to heart disease, and strokes, and things like that. So, it’s kind of this cascading effect…
—Key Informant Interviewee
Adolescents
In 2017, 24.6% of high school students in the District reported that they get sufficient sleep, which is consistent with the national average [3]. However, the prevalence of sufficient sleep varied by sex, race/ethnicity, age, and sexual orientation among District students.


Infants
Each year 3,500 sleep-related infant deaths occur in the U.S. [4]. Almost 80% of sleep-related infant deaths occur before infants are 4 months old. In DC, the rate of sleep-related infant deaths has fluctuated over the past decade. Sleep-related infant deaths include deaths that result from unsafe sleep environments, inappropriate bedding, and unsafe co-sleeping/bed-sharing.

DC Health is working with many community partners to address infant mortality and promote sleep health best practices for infants in the District. Nearly half of caregivers report they did not receive correct advice on safe sleep practices from their healthcare providers. Caregivers who received correct advice were more likely to have safe-sleep practices with their babies [5].
Through partnerships and collaborations, DC residents can receive safe sleep education and a portable crib for their infant to ensure infants are sleeping safely. Putting a baby to sleep face up, alone, and in a crib reduces the chance of death caused by unsafe sleep practices.
Assets and Resources
• DC Health Safe Sleep Program
Agencies Providing Safe Sleep Education & Portable Cribs
• CentroNia (Habla español) Ward 1
(202) 332-4200
• The Northwest Center (Habla español), Ward 1-8
(202) 483-7008
• East River Family Strengthening Collaborative, Ward 7
(202) 397-7300
• Far Southeast Family Strengthening Collaborative, Ward 8
(202) 889-1425
Promising Practices & Policies
• SH-I Advocacy for adoption of clinical guidelines for the evaluation, management, and long-term care of obstructive sleep apnea in adults (Adult Obstructive Sleep Apnea Task Force of the American Academy of Sleep Medicine).
• SH-II Improve collaboration to create a streamlined strategy for increasing awareness and coordinating re-sources to improve sleep health.
• MICH-I Increase the minimum wage to a living wage.
Citations & Additional Data Resources
1. CDC. Sleep and Sleep Disorders. 2018
3. DC YRBS 2017
4. CDC. Safe Sleep. 2018
5. CDC. Safe Sleep Infographic. 2018
Photo Credit:
Photo by Matheus Vinicius on Unsplash
Photo by Tonny Tran on Unsplash