Long Days, Sleepless Nights

Thomas Mellman

During the pandemic, Black Americans are battling insomnia.

“According to our surveys, there’s a greater distress about the impact of racism than about COVID-related stress, though COVID definitely has an impact,” says Dr. Thomas Mellman, a Howard University Hospital psychiatrist and director of the Clinical Translational Science and Sleep Stress research programs at Howard University School of Medicine, where he also is investigating the effects of trauma and stressful neighborhood environments on sleep and, by extension, overall health.

Funded by the National Heart, Lung and Blood Institute, his team’s survey of their 18- to 35-year-old respondents, all of whom are Black, found 61 percent had clinically diagnosable insomnia symptoms; 45 percent said their sleep had worsened during the pandemic. A sustained restriction of slumber blocks the hormones that gauge and regulate hunger, which can lead to overeating and obesity. Without an optimum of at least seven hours of shut-eye during a 24-hour period, mental agility and memory slip. Moods are disrupted, energy levels plummet.

Fundamentally, the study is being conducted amid a current iteration of racial tensions and a pandemic that, research shows, has kept record numbers of people wide awake worldwide. COVID-19, Mellman adds, is a “more novel challenge” whose end seems reasonably in sight.

Not so with racism. Areas to be further explored include the conundrum over why some people suffer fewer of racism’s debilitating mental and physical effects. What makes one person more or less resilient than another?

The study comes as Howard expands its portfolio of big-vision research projects, including ones managed through the Georgetown-Howard Universities Center for Clinical Translational Sciences, launched expressly to examine health care and outcomes among persons of color, the disabled, the aged and others from comparatively lesser-served, lesser-resourced groups.

Mellman and colleagues are also developing a database of Howard patients hospitalized for COVID, from which researchers will look at “risks and protective factors.” According to Mellman, these include “medication exposures, demographics, the neighborhoods where people lived before coming to our hospital.”

How might, say, heart health be affected by witnessing police brutality or navigating a volatile community or workplace? “One of the things we ask game-changing.” people [to track] approximately a half-hour before they go to sleep is, ‘How safe do you feel now?’ A feeling of safety engenders a physiological relaxation that is important to sleep,” Mellman says. “When people suffer with post-traumatic stress disorder, their lives can be restricted. They have disturb- ing dreams that interfere with sleep. They are reactive to various triggers. Some people with PTSD can be conflict-avoidant, which can hold them back in relationships, in an occupation.”

That kind of people-focused, real-world research places Howard squarely among institutions studying – with what some describe as heightened intensity – the interconnectedness of place, income, economic status, education, blatant aggression, micro-aggression and other forces, including race-driven ones, among the social determinants of health. It is pivotal, crucial work. “We need to understand those determinants comprehensively,” Mellman says. “COVID has been both an example and magnifier of those disparities. It’s important that the populations Howard serves are represented in the research. ... What we learn right now, during COVID, will have applications far beyond COVID.”

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