Poor Sleep Health Prevalent Among Sexual Minority Groups

Sexual minority groups, including gay, lesbian, and bisexual individuals, are reported to have poor sleep, with their minority status exacerbating the effect. These are the findings of a study published in the journal Behavioral Sleep Medicine.

While there are reports suggesting that individuals from sexual minority groups may have suboptimal sleep, there are only few studies that have used standard sleep measures for assessment.

Researchers explored sleep health and quality among sexual minority groups, as well as the effect of different identities and identity processes on sleep.

Eligible participants were aged between 18 and 74 years and were from a sexual minority group. Sociodemographic data, including age, gender, sexual orientation, ethnicity, and relationship status, were collected from all participants. In addition, measures of discrimination, identity resilience, social support, depression, anxiety, and sleep quality were also recorded.

The researchers used the Pittsburgh Sleep Quality Index (PSQI) to evaluate sleep quality, and the Hospital Anxiety Depression Scale (HADS) to measure anxiety and depression on a 4-point Likert scale.

A total of 309 participants (52.4% men; bisexual, 70.0%; White, 87.0%) were enrolled in the study.

While there were no differences in demographics, wellbeing, and body mass index (BMI) among sexual minority groups, there were differences in BMI and life satisfaction. Men who were gay had higher BMI than those who were bisexual; women who were lesbian had higher life satisfaction than other groups. Individuals who were bisexual vs other minorities had more challenges, concealment, uncertainty, and discrimination. However, sleep measures, except higher levels of insomnia, did not differ by sexual orientation.

While individuals who were lesbian and gay both had similar levels of anxiety and depression, those who were bisexual had a higher incidence of anxiety and depression.

The researchers noted that participants met the criteria for insomnia (subthreshold: 39.2%; moderate: 14.6%; severe: 4.6%). In addition, a significant percentage (89.6%) of participants exceeded the threshold for poor sleep quality (PSQI >5).

Evaluation of sleep measures showed that higher BMI and levels of depression and anxiety are associated with worse sleep, while higher levels of life satisfaction was associated with better sleep and lower levels of insomnia.

In addition, being more open about sexuality and having fewer sexual identity challenges resulted in better sleep quality. Even after adjusting for BMI, life satisfaction, anxiety, and depression, levels of insomnia were higher in those who were bisexual (9.6; 95% CI, 8.8-10.4) compared with those who were lesbian or gay (7.8; 95% CI, 6.6-9.0).

“… [D]ata reported in this study provide important practical and theoretical insights into how and why sexual orientation may affect sleep,” the researchers concluded.