A longitudinal examination of psychosocial mechanisms linking discrimination with objective and subjective sleep

Natalie D Dautovich; Morgan P Reid; Sarah M Ghose; Giyeon Kim; Caitlan A Tighe; Kristy D Shoji; Wendy Kliewer

doi:10.1016/j.sleh.2023.06.007

A longitudinal examination of psychosocial mechanisms linking discrimination with objective and subjective sleep

Sleep Health. 2023 Oct;9(5):654-661. doi: 10.1016/j.sleh.2023.06.007. Epub 2023 Jul 21.

Authors

Natalie D Dautovich¹, Morgan P Reid², Sarah M Ghose², Giyeon Kim³, Caitlan A Tighe⁴, Kristy D Shoji⁵, Wendy Kliewer²

Affiliations

¹ Psychology Department, Virginia Commonwealth University, Richmond, Virginia, USA. Electronic address: ndautovich@vcu.edu.
² Psychology Department, Virginia Commonwealth University, Richmond, Virginia, USA.
³ Department of Psychology, Chung-Ang University, Seoul, South Korea.
⁴ VISN 4 Mental Illness, Research, Education, and Clinical Center (MIRECC), VA Pittsburgh Healthcare System, Pittsburgh, Pennsylvania, USA.
⁵ Eastern Colorado Health Care System - Mental Health Service, Kerrville VA CLC, Kerrville, Texas, USA.

PMID: 37482456
DOI: 10.1016/j.sleh.2023.06.007

Abstract

Objective: Although chronic discrimination negatively impacts sleep, the cross-sectional nature of most research limits the understanding of how changes in discrimination over time are associated with sleep health. Therefore, the aims of this study were to explore the: (1) longitudinal association between daily discrimination and subjective and objective sleep; (2) mediating roles of anxiety and social well-being; and (3) moderating role of change in discrimination over time.

Methods: An archival analysis was completed using data from the Midlife in the United States study across 3 timepoints. Participants were primarily female-identifying, white, and college-educated. Measures included Pittsburgh Sleep Quality Index (N = 958), sleep diaries (N = 307), and actigraphy (N = 304). Daily discrimination, the Social Well-Being Scale, and the Mood and Anxiety Symptom Questionnaire were also administered. Moderated parallel mediations were performed using the PROCESS macro controlling for depressive symptoms.

Results: More discrimination at time 1 was associated with worse global sleep quality (b = 0.10 and p = .001) and daily sleep quality (b = 0.03 and p = .02) and worse objective sleep-onset latency (b = 0.93 and p = .02), wake after sleep onset (b = 1.09 and p = .002), and sleep efficiency (b = -0.52 and p < .001) at time 3. Social well-being mediated the associations between discrimination and subjective global sleep quality 95% CI [0.00, 0.03] and daily sleep quality 95% CI [0.00, 0.01] and objective TST 95% CI [0.00, 0.96] when discrimination was increasing or chronic. Anxiety mediated the discrimination-global sleep quality association regardless of changes in discrimination.

Conclusions: Discrimination showed durable associations with a broad array of sleep outcomes across a 10-year period. Anxiety and social well-being linked discrimination to subjective sleep outcomes, illustrating the importance of psychosocial well-being for sleep health in those experiencing discrimination.

Keywords: Actigraphy; Anxiety; Discrimination; Sleep; Sleep diary; Social well-being.