Do Sleep Problems Exacerbate the Mental Health Consequences of Discrimination Among Adults?

Overview

Journal Psychosom Med

Specialty Psychiatry

Date 2024 Apr 8

PMID 38588054

Authors

Thomas E Fuller-Rowell

Megan M Zeringue

Ekjyot K Saini

Tiffany Yip

Mona El-Sheikh

Affiliations

Soon will be listed here.

Abstract

Objective: An emerging literature suggests that sleep may play an important role in moderating the association between discrimination and mental health problems among adolescents. However, few if any studies have considered this topic among adults. Addressing this knowledge gap, the current study examined multiple sleep parameters as moderating variables in the association between discrimination and mental health problems among adults.

Methods: Participants were 874 adults residing in small towns and semirural contexts within the Southeastern region of the United States ( Mage = 41 years, SD = 7; 57% female; 31% Black, 69% White; 52% income-to-needs < 2). Sleep duration and night-to-night variability in duration were assessed using wrist actigraphy. Established self-report measures were used to assess global sleep problems, experiences of discrimination, and mental health problems (anxiety, depression, and externalizing symptoms).

Results: Experiences of discrimination were associated with more depression, anxiety, and externalizing problems. Two out of three sleep parameters were found to moderate the effects of discrimination on mental health. The association between discrimination and externalizing problems (but not anxiety or depression) was attenuated among those with less night-to-night variability in sleep duration. The associations between discrimination and anxiety and externalizing problems (but not depression) were attenuated among those with fewer global sleep problems. Less variability in sleep duration and fewer global sleep problems were also directly associated with lower levels of depression, anxiety, and externalizing problems.

Conclusions: Greater consistency in sleep duration from night-to-night, and fewer overall sleep problems appear to mitigate risk of mental health problems among adults, particularly in contexts where discrimination is prevalent.

References

Fuller-Rowell T, Nichols O, Burrow A, Ong A, Chae D, El-Sheikh M . Day-to-day fluctuations in experiences of discrimination: Associations with sleep and the moderating role of internalized racism among African American college students. Cultur Divers Ethnic Minor Psychol. 2020; 27(1):107-117. DOI: 10.1037/cdp0000342. View

Buysse D, Reynolds 3rd C, Monk T, BERMAN S, Kupfer D . The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989; 28(2):193-213. DOI: 10.1016/0165-1781(89)90047-4. View

Fuller-Rowell T, Curtis D, El-Sheikh M, Duke A, Ryff C, Zgierska A . Racial discrimination mediates race differences in sleep problems: A longitudinal analysis. Cultur Divers Ethnic Minor Psychol. 2016; 23(2):165-173. PMC: 5243865. DOI: 10.1037/cdp0000104. View

Park K, Kim J . Longitudinal association between perceived discrimination and sleep problems among young adults in the United States: Tests of moderation by race/ethnicity and educational attainment. Soc Sci Med. 2023; 321:115773. DOI: 10.1016/j.socscimed.2023.115773. View

Martin-Pinon O, McWood L, Erath S, Hinnant B, El-Sheikh M . Maternal psychological control and adolescent adjustment: Sleep as a moderator. J Sleep Res. 2023; 33(1):e13986. DOI: 10.1111/jsr.13986. View

He F, Bixler E, Liao J, Berg A, Kawasawa Y, Fernandez-Mendoza J . Habitual sleep variability, mediated by nutrition intake, is associated with abdominal obesity in adolescents. Sleep Med. 2015; 16(12):1489-94. PMC: 4662770. DOI: 10.1016/j.sleep.2015.07.028. View

Fuller-Rowell T, Curtis D, Chae D, Ryff C . Longitudinal health consequences of socioeconomic disadvantage: Examining perceived discrimination as a mediator. Health Psychol. 2018; 37(5):491-500. PMC: 5926810. DOI: 10.1037/hea0000616. View

Rutter M . Resilience: some conceptual considerations. J Adolesc Health. 1993; 14(8):626-31, 690-6. DOI: 10.1016/1054-139x(93)90196-v. View

Lewis T, Troxel W, Kravitz H, Bromberger J, Matthews K, Hall M . Chronic exposure to everyday discrimination and sleep in a multiethnic sample of middle-aged women. Health Psychol. 2012; 32(7):810-9. PMC: 3654016. DOI: 10.1037/a0029938. View

10.

ElSheikh M, Tu K, Saini E, Fuller-Rowell T, Buckhalt J . Perceived discrimination and youths' adjustment: sleep as a moderator. J Sleep Res. 2015; 25(1):70-7. PMC: 4751069. DOI: 10.1111/jsr.12333. View

11.

Mezick E, Matthews K, Hall M, Kamarck T, Buysse D, Owens J . Intra-individual variability in sleep duration and fragmentation: associations with stress. Psychoneuroendocrinology. 2009; 34(9):1346-54. PMC: 2743778. DOI: 10.1016/j.psyneuen.2009.04.005. View

12.

Pascoe E, Richman L . Perceived discrimination and health: a meta-analytic review. Psychol Bull. 2009; 135(4):531-54. PMC: 2747726. DOI: 10.1037/a0016059. View

13.

Verweij I, Romeijn N, Smit D, Piantoni G, van Someren E, van der Werf Y . Sleep deprivation leads to a loss of functional connectivity in frontal brain regions. BMC Neurosci. 2014; 15:88. PMC: 4108786. DOI: 10.1186/1471-2202-15-88. View

14.

Charest J, Grandner M . Sleep and Athletic Performance: Impacts on Physical Performance, Mental Performance, Injury Risk and Recovery, and Mental Health. Sleep Med Clin. 2020; 15(1):41-57. PMC: 9960533. DOI: 10.1016/j.jsmc.2019.11.005. View

15.

Massar S, Liu J, Mohammad N, Chee M . Poor habitual sleep efficiency is associated with increased cardiovascular and cortisol stress reactivity in men. Psychoneuroendocrinology. 2017; 81:151-156. DOI: 10.1016/j.psyneuen.2017.04.013. View

16.

Richeson J, Trawalter S . Why do interracial interactions impair executive function? A resource depletion account. J Pers Soc Psychol. 2005; 88(6):934-947. DOI: 10.1037/0022-3514.88.6.934. View

17.

El-Sheikh M, Shimizu M, Erath S, Philbrook L, Hinnant J . Dynamic patterns of marital conflict: Relations to trajectories of adolescent adjustment. Dev Psychol. 2019; 55(8):1720-1732. PMC: 6646101. DOI: 10.1037/dev0000746. View

18.

Paradies Y, Ben J, Denson N, Elias A, Priest N, Pieterse A . Racism as a Determinant of Health: A Systematic Review and Meta-Analysis. PLoS One. 2015; 10(9):e0138511. PMC: 4580597. DOI: 10.1371/journal.pone.0138511. View

19.

Hall M, Brindle R, Buysse D . Sleep and cardiovascular disease: Emerging opportunities for psychology. Am Psychol. 2018; 73(8):994-1006. PMC: 6220679. DOI: 10.1037/amp0000362. View

20.

Hall M, Muldoon M, Jennings J, Buysse D, Flory J, Manuck S . Self-reported sleep duration is associated with the metabolic syndrome in midlife adults. Sleep. 2008; 31(5):635-43. PMC: 2398755. DOI: 10.1093/sleep/31.5.635. View