As sleep disorders have become more prevalent in recent years, they have emerged as a major public health concern and health equity issue given that members of low-income communities and minority groups are more likely to have sleep disorders that go undiagnosed. The Hope Clinic is a nonprofit organization dedicated to supporting uninsured individuals with access to sleep care, dental care, behavioral health care and more. University of Michigan professors have recently partnered with the clinic to create a free sleep service in hopes of addressing disparities in sleep disorder diagnoses in southeast Michigan.
Dr. Galit Levi Dunietz, a U-M associate professor of neurology, alongside her department chair Dr. Dawn Kleindorfer, helped facilitate the partnership. In an interview with The Michigan Daily, Dunietz said disparities in access to health care can be especially harmful when it comes to diagnosing sleep disorders.
“As a public health professional, I was always cognizant of health equity,” Galit said. “I realized that when I joined sleep medicine, that sleep medicine is an expensive practice because the evaluation and the treatment of sleep disorders rely on equipment.”
The most common sleep disorder is sleep apnea, which is characterized by abnormal breathing patterns during sleep. The machine used to treat sleep apnea, however, is expensive and not always accessible to low-income communities where sleep disorders are more prevalent.
Dunietz met with Dr. Martha Kershaw from the Hope Clinic, and together, they started the sleep service in September 2021. Dunietz said the clinic largely sees people from low-income and minority communities.
“Sleep is impacted by not only physical health but mental health,” Dunietz said. “The people we see at the clinic are people who live in poverty, immigrants, refugees, people who have a lot of life stressors. … We see a very heavy burden among people from lower socioeconomic status, and these people have less access to health care.”
The clinic allows people to be evaluated for various health issues, including sleep apnea, and then helps to connect them with treatment options for free.
LSA senior Eric Chen, member of the U-M chapter of the American Medical Association Medical Student Section, said that while the conversation surrounding health equity continues to develop, it is important to consider that people in low-income communities usually receive worse health care.
“Certain groups of people do receive lower quality of care because they are in areas that have less access to health care or less resources to health care and they themselves usually have worse health care coverage,” Chen said.
Dr. Ronald Chervin, the section head for sleep disorders, U-M professor of sleep medicine and neurology and a Hope Clinic volunteer, said he provided medical input about how the service could operate in southeast Michigan. Chervin said while sleep disorders are common in the general population, stressors can be especially common in low-income communities facing constrained resources.
“If you’re talking about low-income communities, there is probably an increase in several types of sleep issues including insomnia, and that can relate to stresses encountered during their lives,” Chervin said. “Sleep apnea is especially common in people who are overweight or obese, and sometimes, a healthy diet is hard to afford in a low-income setting.”
Chen said he believes access to sleep care is critical to overall human health.
“Sleep controls a lot of your hormone activities,” Chen said. “Sleep is also when a lot of the brain activities and memory consolidation actually occurs. … That’s when a lot of the connections and synapses in your brain strengthen, and without sleep, you don’t have those connections.”
Dunietz said sleep care continues to be a focus of medical research because of its connection to a variety of health outcomes.
“When we treat (patients’) sleep apnea, we also improve their quality of life overall, and sometimes their physical health too,” Dunietz said. “They are very committed to this treatment because they see the improvement in their life and health.”
Daily Staff Reporter Gillian Reynolds can be reached at gillyr@umich.edu.