Objective To examine violent crime in relation to sleep and explore pathways, including psychological distress, safety perceptions and perceived police presence, that may account for associations.

Methods In 2018, 515 predominantly Black American (94%) adults (Pittsburgh, Pennsylvania, USA) provided survey data: actigraphy-assessed sleep duration and wakefulness after sleep onset (WASO). We estimated pathways from violent crime (2016–2018) to sleep through psychological distress, perceptions of safety and perceived adequacy of police presence.

Results WASO was most strongly associated with violent crimes that were within 1/10 mile of the participant’s home and within the month preceding the interview. Violent crimes were associated with lower perceived safety (β=−0.13 (0.03), p<0.001) and greater WASO (β=5.96 (2.80), p=0.03). We observed no indirect associations between crime and either WASO or sleep duration through any of the tested mediators. Crime was not associated with sleep duration.

Conclusions We demonstrated that more proximal and more recent violent crimes were associated with reduced perceived safety and worse WASO. Differential exposure to violent crime among Black Americans may contribute to health disparities by reducing residents’ perceived safety and sleep health.