Sexual and gender minority sleep: A narrative review and suggestions for future research

Abstract

SummaryThis article reviews a growing body of research that examines sleep among lesbian, gay, bisexual and transgender (LGBT) populations. An extensive search of the literature was conducted using multiple medical and psychological search engine platforms. In total, this search yielded 31 reports that included sleep data collected from sexual and gender minority participants. Overall, research findings are mixed and include several publications of studies conducted in the same sample. Our review suggests that sleep health among LGBT individuals may be an unmet health need. Critically, sleep disturbances affected LGBT subgroups differently based on sex/gender and diverse sexual orientations (e.g., bisexual women). Although not directly tested, evidence from parallel LGBT health research suggests that minority stress may contribute to these observed sleep disparities and will need to be directly assessed in future studies. In sum, continued investigation of sleep disparities among sexual and gender minority communities is needed, as is the inclusion of sleep health in theoretical models of LGBT health disparities. Given the importance of sleep in overall mental and physical health, addressing sleep health may serve to promote and protect healthy functioning among LGBT individuals.

Human studies of mitochondrial biology demonstrate an overall lack of binary sex differences: A multivariate meta‐analysis

“…This finding suggests that variation in hormone levels—including between individuals with the same chromosomal sex—could influence mitochondrial behavior regardless of sex assigned at birth. Moreover, independent of biological sex, gender (e.g., identifying as a woman, man, or another identity; being more traditionally masculine or feminine) influences diet, 60–62 physical activity, 63–66 sleep, 67–69 and other health behaviors 70–72 . In turn, these factors can drive physiological differences in mitochondrial biology.…”

Differences in Multimorbidity among Cisgender Sexual Minority and Heterosexual Adults: Investigating Differences across Age-Groups

“…Our findings have important implications for future research on multimorbidity in sexual minority adults across the life course. Despite higher rates of risk factors for chronic diseases including tobacco use (Blosnich et al, 2013), heavy drinking (Caceres, Makarem, et al, 2019; Dermody et al, 2014), and sleep disturbances (Butler et al, 2020; Caceres, Hickey, et al, 2019), the study of multimorbidity among sexual minority adults is limited. Even fewer studies have examined the experiences of sexual minority adults with multimorbidity.…”

“…The minority stress model postulates that exposure to unique minority stressors (e.g., sexual orientation–based discrimination, bias-motivated violence, and expectations of rejection) contributes to negative health outcomes among sexual minority individuals. A growing body of research indicates that sexual minority adults have a higher prevalence of current tobacco use (Blosnich et al, 2013), heavy drinking (Caceres, Makarem, et al, 2019; Dermody et al, 2014), and short sleep duration (Butler et al, 2020; Caceres, Hickey, et al, 2019) relative to heterosexual adults. In addition, sexual minority adults report higher rates of mental health conditions (e.g., depression, anxiety, and suicidal ideation) (Plöderl & Tremblay, 2015).…”

Associations Between Transgender Identity, Sleep, Mental Health and Suicidality Among a North American Cohort of College Students

“…In a recent review on sleep among gender minority participants, only 4 of 31 studies included transgender subjects. 34 Poor sleep quality is prevalent in non-college transgender women (79.2%) and transgender men (81.2%). 13 A qualitative study of transgender adults, of which 25% were between the ages of 18-21 years-old, observed high proportions of poor sleep quality.…”