Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Jun;8(3):334-345.
doi: 10.1016/j.sleh.2022.03.004. Epub 2022 Apr 30.

Adapting the Health Stigma and Discrimination Framework to understand the association between stigma and sleep deficiency: A systematic review

Affiliations

Adapting the Health Stigma and Discrimination Framework to understand the association between stigma and sleep deficiency: A systematic review

Uzoji Nwanaji-Enwerem et al. Sleep Health. 2022 Jun.

Abstract

Objective: Sleep deficiency and sleep disorders disproportionally affect socially disadvantaged and marginalized individuals and groups. Recent evidence suggests that stigma, a social process characterized by labeling, stereotyping, and prejudice, is associated with sleep characteristics.

Purpose: Guided by the Health Stigma and Discrimination Framework, the purpose of this systematic review is to describe associations between dimensions of stigma and sleep deficiency and to identify future directions for research.

Methods: We searched the OVIDPsycINFO, OVIDEMASE, OVIDMEDLINE, and CINAHL databases for empirical research studies that reported relationships between the 3 dimensions of stigma-internalized, perceived, and anticipated-and characteristics of sleep deficiency-duration, continuity/efficiency, timing, alertness/sleepiness, quality, and disorders.

Results: Of 1717 articles, 15 met our inclusion criteria. The most frequently assessed dimensions of stigma were internalized and perceived stigma. Characteristics of sleep deficiency were measured by self-report and included sleep quality, duration, trouble sleeping, and insomnia symptoms. We found consistent evidence that stigma, whether internalized, perceived, or anticipated, is associated with self-reported characteristics of sleep deficiency.

Conclusions: This evidence base can be further strengthened with prospective studies that incorporate both multidimensional measures of stigma and objective measures of sleep characteristics. We outline research implications that can clarify underlying mechanisms and more precisely define the relationships between stigma and sleep and inform interventions to address stigma, improve sleep, and reduce the health inequities that disproportionately affect individuals from socially disadvantaged and marginalized groups.

Keywords: Systematic review; health disparities; sleep; stigma.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.
Adapting the Health Stigma & Discrimination Framework to Understand the Association between Stigma and Sleep Deficiency.
Figure 2.
Figure 2.
Flow chart detailing the systematic search of potential reports and selection process of included studies (n).

References

    1. Buysse DJ. Sleep health: can we define it? Does it matter?. Sleep. 2014;37(1):9–17. Published 2014 Jan 1. doi:10.5665/sleep.3298 - DOI - PMC - PubMed
    1. The State of SleepHealth in America. https://www.sleephealth.org/sleep-health/the-state-of-sleephealth-in-ame.... Published 2020. Accessed August 18, 2020.
    1. Slopen N, Lewis TT, Williams DR. Discrimination and sleep: A systematic review. Sleep Medicine. 2016;18:88–95. - PMC - PubMed
    1. Jackson CL, Powell-Wiley TM, Gaston SA, Andrews MR, Tamura K, Ramos A. Racial/ethnic disparities in sleep health and potential interventions among women in the United States. Journal of Women’s Health. 2020;29(3):435–442. - PMC - PubMed
    1. Williams NJ, Grandner MA, Snipes SA, et al. Racial/ethnic disparities in sleep health and health care: Importance of the sociocultural context. Sleep Health. 2015;1(1):28–35. - PMC - PubMed

Publication types