Asian Americans experience disproportionately high rates of sleep disturbances, yet the multilevel factors driving these disparities remain underexplored. Guided by the socio-ecological model, this review synthesizes the individual/intrapersonal, interpersonal/family, community/occupational, and societal determinants contributing to sleep-related problems among Asian Americans. We conducted a targeted literature search of Google Scholar, MEDLINE, PsycINFO, and Social Science Abstracts for English-language empirical and review studies. Search terms combined "Asian American" or specific ethnic subgroups (e.g., Chinese, Filipino, Hmong, Vietnamese) with sleep-related outcomes (e.g., sleep duration, quality, disorders). Eligible studies were categorized across four ecological levels: individual/intrapersonal, interpersonal/family, community/occupational, and societal.
At the individual and interpersonal levels, acculturative stress, family pressure, and perceived discrimination were consistently linked to shorter sleep duration and poorer sleep quality. Community‑level factors-including low income, crowded housing, and shift work-further compromised sleep health. At the societal level, high uninsured rates, out‑of‑pocket costs, and a shortage of bilingual, bicultural CBT‑I providers and culturally tailored resources impeded help‑seeking and treatment adherence. Importantly, these influences are often intertwined, with upstream societal forces cascading into community conditions, shaping interpersonal dynamics, and amplifying individual stress responses.
Sleep disparities among Asian Americans stem from complex, interacting factors across multiple ecological levels. Interventions must move beyond individual behavior change and incorporate multilevel strategies to address these intersecting barriers, which are essential to improving sleep health in this population.
Acknowledgements: I would like to acknowledge the Kwok lab, specifically my PI, Dr. Gary Kwok and my colleague Shannon Cheung (MSW) for their guidance and collaboration on this project.