2023 Theses Doctoral

Minority Stress and Sleep Health in Sexual and Gender Minorities

Belloir, Joseph Allen

Sexual and gender minority (SGM) adults are a health disparity population at high risk for poor sleep health. A small but growing body of literature has investigated the influence of minority stressors (i.e., distinct and chronic stressors, such as discrimination, related to stigmatized minority status) on sleep health outcomes in SGM adults. However, investigators have yet to comprehensively examine the relationship between minority stressors and poor sleep health in SGM people or factors that potentially mediate or modify this association.

Further, existing studies on sleep health in SGM adults have been limited to self-reported data and by their cross-sectional designs. This dissertation research filled these gaps by using validated subjective and objective measures of sleep health, longitudinal cohort data to examine mechanisms underlying the relationship between minority stress and sleep health outcomes, and ecological momentary assessment to investigate the associations between minority stressors and sleep health outcomes at the day level. Findings indicated that intolerance of uncertainty partially mediated the positive association between experiences of discrimination and short sleep duration in gender minority adults.

Further, greater daily experiences of discrimination were associated with same-night sleep disturbances, while daily anticipated discrimination was associated with next-day sleep related impairment in SGM people of color. Dissertation findings suggest that interventions, such as SGM sensitive, affirmative CBT, can target both minority stressors and mediating variables (e.g., intolerance of uncertainty) and may be beneficial in improving sleep health outcomes in SGM adults.