Racial/Ethnic Variations in the Association Between Sleep Problems and Mental Health

Abstract Racial/ethnic disparities in mental health remain a pressing concern in social work, yet limited research has explored whether commonly experienced stressors differentially affect mental health outcomes across racial/ethnic groups. This study investigated whether race/ethnicity moderates the association between sleep problems and mental health. Data were drawn from the 2022 National Health Interview Survey (N = 25,225). Depressive symptoms were assessed using the eight-item Patient Health Questionnaire, and anxiety symptoms were measured using the seven-item Generalized Anxiety Disorder scale. Sleep problems were evaluated across four dimensions: (1) waking up feeling unrested, (2) difficulty falling asleep, (3) difficulty staying asleep, and (4) use of sleep medication. Race/ethnicity was categorized as non-Hispanic White, Hispanic, Black, and Asian. Results indicated that sleep problems were associated with higher levels of depressive and anxiety symptoms. The positive association between sleep problems and both outcomes was stronger among Hispanic adults compared with non-Hispanic White adults. These differences persisted across several sleep dimensions, including difficulty falling asleep, difficulty staying asleep, and use of sleep medication. Patterns among Black and Asian adults were more varied. These findings underscore the need for social work research and practice to incorporate sleep health into broader efforts to address racial/ethnic mental health disparities.