Does sleep partially mediate the effect of everyday discrimination on future mental and physical health?

Discrimination in Middle Eastern and North African Americans predicts Worse Mental Health as Mediated by Sleep

Discrimination is a salient stressor linked with a variety of health outcomes including depression and anxiety among Middle Eastern and North African Americans (MENA). Among other minoritized racial and ethnic groups, sleep difficulties have been identified as potential mechanisms that explain the relationship between discrimination and mental health. However, this has not been explored within MENA samples. Thus, the focus of this study is to examine if two sleep measures (e.g., sleep disturbance and sleep-related impairment) mediate the relationship between discrimination and two mental health outcomes: depression and anxiety. We recruited 126 MENA adults from across the USA through Prolific. Findings revealed that sleep-related impairment fully mediated the relationship between discrimination and mental health outcomes, whereas sleep disturbances only partially mediated these outcomes. Results suggest sleep difficulties are one pathway that could explain the relationship between discrimination and mental health among MENA. Future work should continue to explore this relationship, as well as investigate discrimination and sleep as possible places of intervention to protect the health of MENA individuals.

Anti-Black violence, discrimination, and sleep difficulties amongst racially diverse Americans: The aftermath of the murder of George Floyd

RATIONALE

Following the murders of George Floyd and other Black Americans during the summer of 2020, there was unprecedented exposure to media-disseminated depictions of anti-Black violence. Little is known about the impact of this widespread form of vicarious racism that was pervasive during that historic time.

OBJECTIVE

The present study applies the concept of vicarious racism to study this secondary exposure to anti-Black violence. We investigated negative impacts of anti-Black violence (NIAV) and personal experiences with discrimination in association with sleep difficulties, a critical intermediary health process.

METHODS

Racially diverse Americans (N = 487) were recruited to participate in a cross-sectional study using an online survey given between December 11, 2020 and February 11, 2021.

RESULTS

Black participants endorsed greater NIAV than Asian, Latinx, and White participants. Moreover, Black, Asian, and Latinx participants reported greater direct discrimination than White participants. NIAV and direct discrimination were each associated with more sleep difficulties. Although associations between NIAV and sleep difficulties did not vary by race, race moderated the association between direct discrimination and sleep difficulties. In addition, direct discrimination moderated the association between NIAV and sleep difficulties in an unanticipated direction: the link between NIAV and sleep difficulties was weaker for those experiencing more direct discrimination.

CONCLUSION

Findings suggest that anti-Black violence and police brutality not only impact direct victims but have widespread vicarious impacts on racially diverse Americans, and highlight that vicarious anti-Black racism and discrimination are important issues of public health.

Financial Strain and Psychological Distress Among Middle-Aged and Older Adults: A Moderated Mediation Model

This study investigates the association between financial strain and psychological distress among middle-aged and older adults, exploring how this association is mediated by sleep problems and moderated by marital status. A subsample of 12,095 adults aged 50 and older was selected from the 2018 National Health Interview Survey. Results showed that financial strain was associated with higher psychological distress, and sleep problems partially mediated this association. Marital status moderated the association between sleep problems and psychological distress, and between financial strain and psychological distress, but not between financial strain and sleep problems. These findings partially support the stress-buffering role of marriage. The study offers valuable insights into the complex relationship between financial strain, sleep problems, marital status, and psychological distress among middle-aged and older adults in the United States, highlighting the need for interventions targeting financial stressors and sleep problems, especially for unmarried individuals, to improve mental health outcomes in this population.

Social class discrimination during adolescence as a mediator of socioeconomic disparities in actigraphy-assessed and self-reported sleep

OBJECTIVE

To examine social class discrimination as a mediator of socioeconomic disparities in sleep outcomes in an adolescent sample.

METHODS

Sleep was assessed from established actigraphy (efficiency, long wake episodes, duration) and self-report (sleep/wake problems, daytime sleepiness) measures among 272 high school students in the Southeastern region of the United States (35% low income; 59% White, 41% Black, 49% female, Mean age = 17.3, SD = 0.8). Social class discrimination was assessed using a new measure, the Social Class Discrimination Scale (SCDS; 22-items), and an established measure, the Experiences of Discrimination Scale (EODS; 7-items). Socioeconomic disadvantage (SED) was measured as an aggregate of six indicators.

RESULTS

The SCDS was associated with sleep efficiency, long wake episodes, sleep/wake problems and daytime sleepiness (but not sleep duration), and significantly mediated the socioeconomic gradient in each sleep outcome. Black males experienced higher levels of social class discrimination than Black females, White males, or White females. A race by gender moderation effect was evident for two of the five sleep outcomes (sleep efficiency and long wake episodes) suggesting a stronger association between social class discrimination and sleep problems for Black females than White females but no clear race differences among males. The EODS was not associated with objective sleep outcomes or SED but was associated with self-reported sleep and showed a similar pattern of moderation effects.

CONCLUSIONS

Findings suggest that social class discrimination may contribute to socioeconomic disparities in sleep problems, with some variability across measures and demographic groups. Results are discussed in light of evolving trends in socioeconomic health disparities.

Discrimination and Health Among First-Generation Hispanic/Latinx Immigrants: the Roles of Sleep and Fatigue

INTRODUCTION

A growing literature documents the associations between discrimination and health. Emerging evidence suggests that among Hispanic/Latinx immigrants, discrimination leads to the deterioration of health outcomes over time. While sleep has been proposed as an important mediator of the relationship between discrimination and health, few studies have explicitly investigated this pathway, particularly among Hispanic/Latinx populations.

OBJECTIVE

To investigate the relationships between racial/ethnic discrimination, sleep, and physical and mental health among Hispanic/Latinx immigrants in the USA. Data and Methods Using data from a parent study of first-generation Hispanic/Latinx immigrants in the southeastern USA, we conducted sequential mediation analyses using the bootstrapping method to investigate whether self-reported sleep duration, sleep quality, and fatigue mediate the relationship(s) between self-reported discrimination, as measured by the discrimination subscale of the Riverside Acculturative Stress Inventory, and self-reported physical and mental health.

RESULTS

Nocturnal awakenings, fatigue, and sleep quality were statistically significant sequential mediators of the relationship between discrimination and physical health (b = -.001, SE = .001, CI [-.0027, -.0001]); fatigue alone also mediated this relationship (b = -.01, SE = .01, CI [-.0279, -.0003]). Nocturnal awakenings, fatigue, and sleep quality were also significant sequential mediators of the relationship between discrimination and mental health (b = -.001, SE = .001, CI [-.0031, -.0001]).

CONCLUSION

Sleep and fatigue play an important role in linking discrimination and health among first-generation Hispanic/Latinx immigrants. The development and implementation of interventions that focus on reducing fatigue among this population could mitigate the effects of unfair treatment on health outcomes.

Sleep, Emotions, and Sense of Belonging: A Daily Experience Study

Sleep has strong influences on affective and social experiences. However, less is known about the reciprocal effects of sleep, affect, and social experiences at a daily level, and little work has considered racial/ethnic minorities at high risk for social disconnection and discrimination. A 7-day daily experience study assessed the bidirectional relationships between daily sleep quality, affect, social experiences, and overall well-being among a sample of Latinx undergraduates (N = 109). Each morning, participants reported on their previous night's sleep. Each evening, they reported their positive and negative affect, experiences of belonging and unfair treatment, and overall well-being that day. Results indicate that, at a daily level, sleep quality predicts next-day affect, belonging, and well-being. Reciprocally, only daily well-being predicts sleep quality. Findings highlight sleep as a potentially powerful antecedent of affective and social experiences likely to be particularly potent for underrepresented minority groups.

Supplementary Information

The online version contains supplementary material available at 10.1007/s42761-021-00088-0.

Social stress and risk of declining cognition: a longitudinal study of men and women in the United States

Limited research is available on the relationship between social stress and risk of declining cognition. We sought to examine whether social stress has adverse effects on risk of declining episodic memory and executive functioning in aging individuals. We used data from the MIDUS study, a national probability sample of non-institutionalized, English speaking respondents aged 25-74 living in the 48 contiguous states of the United States. The initial wave (1995) included 4963 non-institutionalized adults aged 32-84 (M = 55, SD = 12.4). We used an analytic sample from MIDUS-II (1996/1997) and MIDUS-III (2013) (n = 1821). The dependent variables are episodic memory and executive functioning, which were assessed with the Brief Test for Cognition (BTACT). The independent variables were social stress variables (subjective social status, family and marital stress, work stress and discrimination). To evaluate episodic memory and executive functioning changes over a time period of 10 years, we estimated adjusted linear regression models. Women report significantly lower subjective social status and more discrimination stress than men across all age groups. Controlling for education and income, age, and baseline episodic memory and executive functioning, lower subjective social status had additional adverse effects on declines in episodic memory in men and women. Marital risk had adverse effects on episodic memory in men but not in women. Daily discrimination had adverse effects on executive functioning on all individuals. Public health strategies should focus on reducing social stress in a socio-ecological perspective. Especially, subjective social status and discrimination stress might be a target for prevention efforts.

Associations Between Everyday Discrimination and Sleep: Tests of Moderation by Ethnicity and Sense of Purpose

BACKGROUND

Everyday discrimination holds pernicious effects across most aspects of health, including a pronounced stress response. However, work is needed on when discrimination predicts sleep outcomes, with respect to potential moderators of these associations.

PURPOSE

The current study sought to advance the past literature by examining the associations between everyday discrimination and sleep outcomes in an ethnically diverse sample, allowing tests of moderation by ethnic group. We also examined the role of sense of purpose, a potential resilience factor, as another moderator.

METHODS

Participants in the Hawaii Longitudinal Study of Personality and Health (n = 758; 52.8% female; mage: 60 years, sd = 2.03) completed assessments for everyday discrimination, sleep duration, daytime dysfunction due to sleep, sleep quality, and sense of purpose.

RESULTS

In the full sample, everyday discrimination was negatively associated with sleep duration, sleep quality, and sense of purpose, while positively associated with daytime dysfunction due to sleep. The associations were similar in magnitude across ethnic groups (Native Hawaiian, White/Caucasian, Japanese/Japanese-American), and were not moderated by sense of purpose, a potential resilience factor.

CONCLUSIONS

The ill-effects on health due to everyday discrimination may operate in part on its role in disrupting sleep, an issue that appears to similarly impact several groups. The current research extends these findings to underrepresented groups in the discrimination and sleep literature. Future research is needed to better disentangle the day-to-day associations between sleep and discrimination, and identify which sources of discrimination may be most problematic.

Differential Impact of Experienced and Anticipated Discrimination on Sleep and Health Among Sexual Minorities

For many lesbian, gay, and bisexual (LGB) individuals, stigma may represent a psychosocial stressor that can disrupt sleep and impair health. The present study tested a stigma model of sleep health to examine whether experienced and anticipated discrimination, as well as associated primal threat, would affect sleep quality and, in turn, physical and mental health among LGB individuals. A total of 401 LGB individuals (201 women and 200 men; mean age = 27.48 years) from Hong Kong, China, provided cross-sectional questionnaire data on experienced and anticipated discrimination, primal threat, sleep disturbance, and self-rated physical and mental health. Path analyses showed that experienced and anticipated discrimination were associated with higher primal threat, which was, in turn, associated with greater sleep disturbance and then poorer physical and mental health. Bootstrap analyses further revealed that experienced and anticipated discrimination had significant indirect effects on sleep disturbance via primal threat and on physical and mental health via primal threat and sleep disturbance. In addition, multi-group analyses demonstrated that the mediation model held across women and men and across lesbian/gay and bisexual individuals. Theoretically, our findings highlighted the importance of considering the differential effects of experienced and anticipated discrimination, as well as the contributive role of primal threat, on the sleep quality and health status of LGB individuals. Practically, our findings pointed to the necessity of developing community-based stigma reduction programs and individual-oriented stigma coping interventions in order to facilitate LGB individuals to reduce discrimination-related primal threat and thereby improve sleep and health.

Gender differences in the relationship between perceived discrimination and personality traits in young adulthood: Evidence using sibling fixed effects

RATIONALE

Although perceived discrimination (PD) is known to be associated with personality traits, family background characteristics may confound this association. Moreover, little is known about whether the relationship differs by gender.

OBJECTIVE

This study investigates whether the association between PD and personality traits is confounded by family background characteristics. Given gender differences in contexts and perceptions of discrimination as well as personality traits, this study also explores whether the association between PD and personality traits differs for men and women.

METHODS

Using data from the National Longitudinal Study of Adolescent to Adult Health, this study examines the association between PD and Big Five personality traits among young adults. This study uses sibling fixed effects models with a lagged dependent variable to account for unobservable family-level characteristics, such as genetics, parental characteristics, family environment, and childhood social contexts.

RESULTS

Sibling fixed effects estimates showed that PD was associated with lower levels of conscientiousness and extraversion and higher levels of neuroticism. There were also gender differences such that PD was associated with lower conscientiousness only for women and lower extraversion only for men. The positive association with neuroticism was apparent for both men and women.

CONCLUSION

This study suggests that the association between PD and personality traits is generally not confounded by stable family-level characteristics shared by siblings. This study also documents gender differences in the relationship between PD and personality traits. Given substantial implications of personality for a broad range of outcomes, especially among young adults, the findings of this study reaffirm the commitment of the whole society to eradicate any form of discrimination.

Sleep Quality in Medical Staffs During the Outbreak of Coronavirus Disease 2019 in China: A Web-Based Cross-Sectional Study

Background: The aim of this study was to describe the sleep quality and its influencing factors among medical workers of different working statuses and staff types during the coronavirus disease 2019 (COVID-19) epidemic. Methods: Through an online questionnaire survey, all medical staffs in Xiangya Hospital were invited to complete sections on general information, the Self-Rating Scale of Sleep (SRSS), the Depression, Anxiety and Stress Scale (DASS-21), the Social Support Rating Scale (SSRS), and the Simplified Coping Style Questionnaire (CSQ). Results: A total of 4,245 respondents completed the survey. Among them, 38.7% had sleep disturbance. After matching, the SRSS scores in the staffs who were assigned to the intensive care unit (ICU) of Union Hospital in Wuhan and working in the epidemic area of Xiangya Hospital were not significantly different (P > 0.05); the SRSS scores in the battlefront staffs were significantly higher than (P < 0.05) those who were not treating patients infected with COVID-19. The SRSS scores of nurses were significantly higher than those of doctors and hospital administrators (P < 0.01). Anxiety, depression, and coping style were associated with sleep disturbance. Conclusion: The sleep quality of the medical staffs has been impaired during the epidemic period, especially among nurses, doctors, and administrators who are working on the front line. Medical institutions should strengthen psychological services and coping strategies for medical staffs.

Racial discrimination, depressive symptoms, and sleep problems among Blacks in the rural South

OBJECTIVES

Experiences of racial discrimination are common for Black Americans and have been associated with depression and sleep disturbance, factors likely involved in the insidious development of health disparities. The current study replicates these associations and examines longitudinal linkages.

METHOD

Black American couples (men: N = 248, Mage = 40, SD = 9; women: N = 277, Mage = 37, SD = 7) and their children, aged 9 to 14 (N = 276, Mage = 11, SD = 1), completed measures of experiences of racial discrimination, depressive symptoms, and sleep problems at baseline and 8-month follow-up. In separate analyses for men, women, and youth, we examined concurrent and prospective associations of racial discrimination with depressive symptoms and sleep problems, then used longitudinal indirect effect models to examine whether depressive symptoms in response to racial discrimination led to increased sleep problems, or vice versa.

RESULTS

Racial discrimination was associated concurrently with depressive symptoms and sleep problems for all family members. Prospective associations were also found with depressive symptoms and sleep problems in fathers and youth, and sleep problems in mothers. Longitudinal models showed significant indirect effects of racial discrimination on change in sleep problems through depressive symptoms for fathers and mothers, and a similar, but nonsignificant, pattern in youth. There were no indirect effects on change in depressive symptoms through sleep problems.

CONCLUSIONS

Persistent associations of racial discrimination with depressive symptoms and sleep problems reflect a lasting impact of racial discrimination. Because discrimination's effects on depression may contribute to increased sleep problems over time, interventions that buffer the effects of discrimination on depressive symptoms may also reduce sleep problems. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Within-person associations between racial microaggressions and sleep among African American and Latinx young adults

Emerging work suggests that experiences of racial discrimination may impact overall sleep health; however, there is limited work on the link between racial microaggressions and sleep. Using weekly diary data, the current study examined young adults' weekly reports of racial microaggressions across 4 weeks, and their relation to weekly reports of sleep-onset latency, reduced total sleep time and poorer sleep quality. This design allowed us to examine how within-person fluctuations in racial microaggressions corresponded with young adults' sleep. Data were collected among 140 African American (62.1%) and Latinx (37.9%) college students attending a Midwestern University. Students were randomly selected to participate; they were, on average, 20.70 years old (SD = 1.22) and the majority were female (69.3%). Participants self-reported their racial microaggressions and sleep behaviours (i.e. sleep-onset latency, total sleep time and sleep quality) each week (across 4 weeks). Multilevel modelling showed significant within-person effects of racial microaggressions for sleep onset and sleep quality, but not for total sleep duration. Specifically, on weeks that individuals reported increases in racial microaggressions, they reported greater sleep-onset duration and poorer sleep quality. The current findings provide preliminary evidence that racial microaggressions are associated with sleep-onset durations and sleep quality among African American and Latinx young adults. Although racial microaggressions are often considered subtle, they may impact the sleep health of young adults in marginalized groups.

Effects of sedentary behavior and physical activity on sleep quality in older people: A cross-sectional study

The aim of this cross-sectional study was to investigate the influence of replacing sedentary time with time engaged in one of two levels of physical activity on sleep quality using an isotemporal substitution model. The participants were 70 community-dwelling older Japanese adults (approximately 70% female). Physical activity types were measured using a triaxial accelerometer and categorized based on intensity as sedentary, light-intensity, and vigorous-intensity. The Pittsburgh Sleep Quality Index assessed subjective sleep quality. Objective sleep parameters were assessed using an actigraph. A series of multi-linear regression models analyzed the statistical relationships. Our findings showed that replacing 30 min of sedentary activity per day with an equal period of light-intensity physical activity significantly influenced sleep quality parameters. However, there was no significant difference in sleep quality when light-intensity activity was replaced with vigorous-intensity activity. Engaging in one activity type means less available time for other types of activity; habitual replacement of sedentary activity with light-intensity physical activity might have long-term benefits on the sleep quality of older people.