Issues

The presence of sleep disorders can have a wide ranging impact on blood pressure; amount of anesthesia needed for a surgical procedure as well as safety factors post surgery; and effectiveness of monitoring of arterial oxygen saturation. The awareness of these issues is critical when faced with either an emerging health issue or managing an ongoing chronic health issue which can impact a sleep patient's quality of life and lead to less optimal health outcomes.

Sleep assessment, diagnosis, and treatment is not attainable for many people in the U.S. because of cost and silos of access. The testing process can be costly for someone without knowing if they need treatment until the sleep study is read by the sleep physician. Medical debt is an issue for millions in the United States.

For some the thought of going to a physician brings up the issue of incurring more medical debt.
Also, if someone wants to track their sleep quality the commercially available sleep trackers are costly and more attainable for those with more financial resources. Sleep is not a luxury and access to healthy sleep should be accessible to all across the lifespan without adding to medical debt.

Signs, symptoms, and prevalence for some sleep disorders (sleep apnea, insomnia, restless leg syndrome) differ for women and a lack of knowledge and gender bias among medical professionals contributes to less women being assessed and properly treated. Furthermore, societal myths about sleep disorders and gender plays a role in minimizing the prevalence of sleep disorders among women. Sleep disorders are a lifespan issue for all, and in particular for women who experience hormonal shifts during the onset of puberty, menstrual cycles, pregnancy, and menopause which can alter sleep architecture. (17) This bias in medicine and societal myths combine to put women at undue health risk for complications from chronic health conditions and can impact quality of life and mortality.

Sleep disorders are under recognized as a co-occurring health condition with many major chronic health issues such as cardiovascular disease, diabetes, liver disease, and eye conditions. The impact this is magnified in underserved populations who suffer disproportionally from major chronic health conditions due to socioeconomic and environmental factors.

Major strides have been made in the last 30 years in the area of sleep disparity research around the impact of the social and environmental determinants of health. Supporting this area of research is important to learn how tailoring culturally appropriate treatment interventions can benefit those who are underserved and underdiagnosed.

Sleep disparity researchers and practitioners have implemented interventions in the community which have made improvements in sleep quality and quantity. The challenge is engaging more underserved communities for participation and learn who is best served by which interventions.

Implicit bias in medical care shows up in the belief that treatments developed in clinical studies involving primarily white subjects is effective for all others. This shows up in a variety of manners-pulse oxygen sensors are not as effective in reading people who have darkened skin (18); Racial and ethnic disparities exist in the utilization of tonsillectomy and adenoid surgery (T&A) for children with Sleep Disordered Breathing enrolled in Medicaid (19).

The impact of sleep disorders and mortality rate for minorities and women in the United States should be treated as a more pressing concern by public health and primary care. Despite the studies which show some correlation, the possible causal factors are complex and multi-factorial.