3281.0 - Minority stress and sleep: How does depression mediate the relationship between stigma and sleep for gay and bisexual men?
Session: Identity and Geography as Social Determinants of Mental Health
Authors: Sally Kirklewski, Erin Nicholson, Trace S. Kershaw
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Abstract
Background
Gay and Bisexual Men and Non-binary Individuals (GBM&N) experience significantly worse sleep outcomes compared to their heterosexual peers. Emerging research indicates that minority stress (e.g., discrimination) may be contributing to these disparities by increasing mental health issues, which then impacts sleep. The aims of this study are to (1) characterize minority stress and sleep quality for GBM&N and (2) to test the pathway of minority stress to sleep through depression symptoms.
Methods
From June 2019 to December 2022 adult GBM&N (N=401) were recruited, as part of the #MVMNT study, through social media, geosocial networking apps, and in-person flyers in the Deep South and Northeast to participate in a longitudinal study focused on understanding health behaviors. Participants answered items about demographics, minority stress (internalized homophobia, discrimination, gay community stress), depression, and sleep quality (i.e., higher values indicating better sleep quality). Three multivariate linear regressions were run to test the pathway of minority stress to sleep quality and indirect effect through depression.
Results
Participants were on average 25 years old (s.d.=4.132), 68% reported a gay and 16% reported a bisexual sexual orientation and participants reported a range of racial ethnic identifications (61% white, 10% Black/African American, 10% Latino/Hispanic, 12% multiracial 4% Asian, and 3% other). The final model was significant (F=27.339, p<.001) and accounted for 23.6% of the variance in sleep quality. Depression symptoms were significantly associated with sleep quality (b=-.087, p<.001). Both internalized homophobia and everyday discrimination were associated with sleep quality initially, but after the addition of depression were no longer significant. Two Sobel tests indicated that depression symptomology fully mediates the relationship between minority stress and sleep quality.
Conclusions
Findings indicate that minority stress has a detrimental impact on their mental health and then on their sleep quality. Interventions to improve sleep quality should focus on attenuating the impact of minority stress on depression or mental health interventions to reduce the impact of depression on sleep. Future research should study the utility of these interventions (e.g., Cognitive Behavioral Therapy for Insomnia, or mindfulness-based interventions) at reducing the impact of minority stress on sleep for GBM&N.