Sleep program efficacy across gender and racial/ethnic groups: A content review and meta-analysis

Female and under-represented minority students (URMs) in higher education disproportionately experience sleep disturbances. Incorporating sleep education and other psychological interventions (e.g., cognitive behavioral therapy for insomnia; CBT-I) into college settings might provide a scalable solution, but it is unknown whether such psychoeducational interventions produce equivalent outcomes across groups. We addressed this question with two approaches. First, we identified 36 US-based studies that had student participants and a psychoeducational sleep intervention. Fifteen authors shared data on sleep knowledge, quality, and/or duration separated by gender and URM groups (N = 599). Hedges' g was computed for each group within each study. Second, we systematically reviewed the content of 21 available programs. We found that, relative to national collegiate data (59.4 % female, 41.5 % URM), females were over-represented (63.4 %) and URM groups were under-represented (23.7 %) in these studies. Interventions improved sleep knowledge (g = 0.69, p<.001) and sleep quality (g = 0.25, p<.001), but not sleep duration (g = 0.13, p = .18). Effect sizes were similar in males, females, URM students, and non-URM students. There were no studies that incorporated financial, social, or neighborhood-level barriers to sleep in students. Future interventions in student groups might be improved by combining individualized, CBT-I-based education while concomitantly addressing environmental/institutional barriers to sleep.