Sexual Orientation and Sleep Behaviors in a National Sample of Adolescents Followed Into Young Adulthood

Abstract

Study Objectives: Sexual minority adolescents experience mental and physical health disparities attributable to increased discrimination and minority stress. These same factors may also impair sleep health, although available literature on this topic is limited. This study examined longitudinal associations between adolescent sexual minority status and seven sleep behaviors in young adulthood and tested depressive symptoms and overweight as mediators. Method: Data were drawn from Waves 2 (11th grade) to 7 (4 years after high school) of the NEXT Generation Health Study, a national longitudinal cohort study of US adolescents (n = 1946; 6.3% sexual minorities). Results: There were no significant sexual orientation disparities in sleep duration, trouble falling asleep, trouble staying asleep, or trouble waking up during young adulthood. Relative to heterosexual females, sexual minority females had higher odds of snoring/stop breathing (36.6% versus 19.2%; adjusted odds ratio = 2.57; 95% confidence interval = 1.30, 5.09) and reported more frequent daytime sleepiness (b = 0.66, 95% confidence interval = 0.05, 1.27). Mediation analyses revealed that female sexual minority status was associated with increased risk of snoring/stop breathing though overweight status (mediated 43.6% of total effect) and was also associated with increased daytime sleepiness through higher depressive symptoms (mediated 70.8% of total effect). Conclusions: Among US youth, no sexual orientation disparities were found except for snoring/stop breathing and daytime sleepiness among females. Sexual orientation disparities in these aspects of sleep are partially due to worse mental and physical health among sexual minority females, highlighting depressive symptoms and overweight problems as potential intervention targets.

Sexual orientation and sleep problem among Chinese college students: Mediating roles of interpersonal problems and depressive symptoms

“…Although most previous studies in western countries used a single item to evaluate sleep quality or sleep difficulties, the trend of increased risk of sleep problems among sexual minorities was in line with this study, regardless of whether for adolescents or adults (Caceres and Hickey, 2020;Crawford and Ridner, 2018;Duncan et al, 2018;Chen and Shiu, 2017;Dai et al, 2020;Blosnich et al, 2013). The current research conclusions on sleep time and sleep delay are still inconsistent (Luk et al, 2019), which may be caused by different evaluation indexes, grouping standards and statistical description methods. More research on sleep problems of sexual minorities is needed.…”

“…Consistent with previous research (Cheng et al, 2012;Madrid-Valero et al, 2017), females had a higher risk of poor sleep quality. This study found that the mediating effects of depressive symptoms in the association between sexual orientation and sleep quality were not moderated by sex, which is different from a longitudinal study resulting from that sexual minority status was associated with daytime sleepiness through depressive symptoms only found in female (Luk et al, 2019). However, our findings were similar to a previous study that reported no sex differences in the effects of sexual minority status on sleep quality through interpersonal problems (Patterson et al, 2018).…”

“…The current research found that depressive symptoms significantly mediated the effect of sexual orientation on sleep quality for Chinese college students, which is in line with two previous studies. Luk et al found that higher depressive symptoms mediated the relationship between sexual orientation and increased daytime sleepiness (mediated 70.8% of total effect) among US female youth (Luk et al, 2019). Patterson and Potter also found that sexual orientation was associated with confirmed sleep difficulties through depressive symptoms among bisexual adults in the United States (Patterson and Potter, 2020).…”

“…Based on existing research on intermediary variables (Luk et al, 2018;Patterson et al, 2018;Patterson and Potter, 2020), we further explored the series of psychosocial (i.e., interpersonal problems and depressive symptoms) mediating mechanisms that are implicated in these disparities. In addition, considering that only a few studies have explored sex differences in mediation pathways from sexual orientation to sleep problems, and presented mixed results (Luk et al, 2019;Patterson et al, 2018), we further investigated the moderating role of sex in the mediation relationships.…”

Sexual orientation and race in daytime sleepiness among cisgender individuals: Roles of discrimination and depressive symptoms.

“…Regarding daytime sleepiness specifically, a meta-analysis indicated that depressive symptoms were positively associated with daytime sleepiness among adolescents (O'Callaghan et al, 2021). Furthermore, in a national longitudinal study of U.S. youth, sexual minority female adolescents reported greater depressive symptoms compared to their heterosexual peers, which in turn predicted more frequent daytime sleepiness (Luk et al, 2019). Therefore, higher depressive symptoms among sexual and racial minority people may lead to more daytime sleepiness.…”