THE ROLES OF INTERSECTIONALITY AND DISCRIMINATION IN POOR SLEEP QUALITY

Daily discrimination is associated with poor sleep quality among marginalized individuals. No study to date has examined whether belonging to multiple stigmatized social groups (e.g., gender, race) is a risk factor for poor sleep quality, and, moreover, whether this association is mediated by daily discrimination experiences. Adopting an intersectional framework, the purpose of this study is to test whether daily discrimination mediates the association between the number of stigmatized identities a person belongs to and objective sleep quality. Participants were selected from the Midlife in the United States (MIDUS) study if they had complete data on perceived daily discrimination and objective sleep quality from the MIDUS II biomarker study (2004-2009; N=301). Objective sleep quality was measured with 7-day actigraphy that calculated sleep onset latency (SOL), wake after sleep-onset (WASO), and sleep efficiency (SE). Daily discrimination was assessed with the Williams Everyday Discrimination Scale. The number of stigmatized identities was calculated as the sum of each participant’s report on gender (1=female), race (1=not white), sexual orientation (1=not heterosexual), and weight (1=BMI of 25 kg/m2 or greater). A mediation analysis was run using the PROCESS macro (Hayes, 2017; model 4; 5000 bootstrap samples) with age, depression, coughing or snoring during sleep (as proxy for sleep-disordered breathing) and use of sleep medications entered as covariates. Results indicated that daily discrimination mediated the association between number of stigmatized identities and objective sleep quality on two of the indicators, SE (95% CI = -.5556, -.0030) and WASO (95% CI = .1021, 1.7149). Mediation is significant when the 95% confidence interval does not include zero. Daily discrimination did not mediate the association between number of stigmatized identities and SOL (95% CI = -.3074, .9674). Results suggest that the number of stigmatized identities a person has predicts poor objective sleep quality via daily discrimination experiences, particularly SE and WASO. An intersectional framework that considers multiple stigmatized identities is useful in understanding the consequences of stigma on experiences of discrimination and sleep. Future directions and implications will be discussed. N/A