Using technology and exposomics to understand and address sleep health disparities

Abstract

Technology, considered devices, systems, and methods that help produce material or social products faster, better, and/or cheaper, have been integrated into almost every aspect of daily living and in ways that can influence sleep and contribute to or mitigate disparities in sleep health. The exposome, which is defined as the cumulative measure of environmental influences and corresponding biological responses throughout the lifespan, provides an opportunity to systematically study the non-genetic drivers of sleep biology and sleep health disparities. This approach leverages technological advancements and provides a mechanism to integrate existing health disparities and equity theories, concepts, as well as methods with environmental health. The goal of incorporating the exposome into population health or epidemiologic research is to improve researchers' ability to illuminate exposure-disease pathways and intervene upon the modifiable contributors to health and disease. Sleep health is no exception. Current scientific research paradigms do not adequately capture the complexity of the relationships between environment, personal health, and population-level disparities. However, the exposome promotes an integrated, systems science approach to understand the causal pathways through which exogenous and endogenous exposures impact biological, psychological, and social systems, and ultimately influence personal health and community-level health disparities. With this understanding, the objective of this article is to summarize the literature on racial/ethnic disparities in sleep health, provide an overview of social and environmental determinants of sleep health disparities, and briefly describe the connection between technology and sleep along with disparities. We will focus on the rationale for applying technology—using an exposome approach—to enhance investigations of sleep health disparities. We will then conclude with relevant challenges and considerations related to implementation.