Racial Discrimination, Financial Strain Disrupt Sleep in First-Time Black Mothers

In addition to the effects of their infant’s sleep, Black mothers experience negative effects to their sleep due to racial discrimination and financial strain. These findings are the results of a study published in Sleep.

Sleep in the postpartum period is essential for the mother’s mental and physical wellbeing; however, it is affected by the stress of managing a new baby, hormonal alterations, physical changes, cognitive shifts, and their infant’s sleep patterns.

Researchers from the University of Georgia in the United States sourced data for this study from the Sleep-Safe: A Strong African American Families Study (ClinicalTrials.gov Identifier: NCT03505203). Black women (N=212; mean age, 22.7 years; Hispanic, 1.4%) with a first-born infant were recruited for the study between 2018 and 2021. The women were evaluated for racial discrimination using the Schedule of Racist Events and financial strain using the Unmet Material Needs (UMN) scale at 1 week postpartum, by actigraphy at 8 weeks postpartum, and for self-reported sleep outcomes at 1, 8, and 16 weeks postpartum. In addition, women were evaluated for infant sleep using the Brief Infant Sleep Questionnaire (BISQ) at 8 and 16 weeks postpartum. The women were randomly assigned to receive a responsive parenting or child safety intervention.

Among the women participants, 62.3% attended or completed high school, 84.5% were covered by Medicaid, 76.4% were enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and 49.0% were enrolled in the Supplemental Nutrition Assistance Program (SNAP).

Racial discrimination at week 1 was correlated with financial strain at week 1 (r, 0.20; P <.01) and financial strain at week 1 correlated with working at week 8 (r, -0.16; P <.05), infant sleep at week 16 (r, 0.16; P <.05), and baby’s sleep location at week 16 (r, -0.15; P <.05).

Self-reported sleep difficulties at week 1 correlated with sleep difficulties at weeks 8 (r, 0.54; P <.001) and 16 (r, 0.31; P <.001) and total sleep time at week 8 (r, -0.22; P <.01).

In the adjusted analyses, self-reported sleep difficulties at week 1 associated with racial discrimination (b, 1.24; P <.001) and at week 16 with financial strain (b, 0.52; P =.007), total sleep time variability associated with racial discrimination (b, 12.89; P =.005), and midpoint sleep variability associated with financial strain (b, 9.77; P =.02).

The associations were not affected by including infant sleep quality, infant feeding strategy, baby’s sleep location, employment status, relationship status, maternal age, or intervention assignment.

This study may have been limited by not collecting actigraphy data during naps and the fact that discrimination and financial strain outcomes were only assessed at week 1.

“[T]hese findings regarding the contributions of racial discrimination and financial strain to new Black mothers’ postpartum sleep difficulties, beyond the effects of infant sleep, add to a growing body of literature demonstrating the importance of social determinants of health in creating sleep difficulties.”