Nearly 70 million Americans have a sleep disorder, the most common of which is insomnia. But the condition is not equally distributed among races. Of the 33% to 50% of American adults experiencing symptoms of sleeplessness, Black women make up a large portion. Studies on the effective treatment of insomnia in the same group could help prevent adverse health outcomes.
Researchers from the Slone Epidemiology Center (SEC) at Boston University and the Division of Sleep Medicine at Harvard Medical School have found that cognitive behavioral therapy for insomnia (CBT-I) delivered through the Internet is highly effective for Black women.
A team of researchers conducted a randomized controlled trial of more than 300 Black women with insomnia. The participants were selected from Boston University’s Black Women’s Health Study (BWHS): a large follow-up study of Black women that has been in progress since 1995. It was a blinded trial. The participants were unaware of their group assignment.
Three types of treatments were delivered through the internet to the participants:
- Sleep Healthy Using the Internet (SHUTi)
- SHUTi-BWHS, a different version of SHUTi developed specifically for Black women adjusted for their culture
- Patient education about sleep (PE).
Women in SHUTi and SHUTi-BWHS were offered a six-module CBT program for insomnia that addresses various aspects of sleep. In contrast, the PE group was offered sleep education material such as sleep hygiene recommendations. The SHUTi-BWHS program was specifically tailored for Black women and the content included only Black patients and sleep experts.
Results showed that participants in both SHUTi and SHUTi-BWHS groups had a greater improvement in their symptoms compared with the third, PE group. More women in the SHUTi-BWHS group completed the program than those in the SHUTi group. Culturally tailored Internet-delivered treatment options for insomnia among Black women were found to be far more accessible and engaging.
Research tailored to find out effective and accessible treatment options for Black people — and other racial and cultural groups — is an important step towards reducing racial disparity in the healthcare system.