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Association Between Discrimination and Objective and Subjective Sleep Measures in the Midlife in the United States Study Adult Sample

Owens, Sherry L. PhD; Hunte, Haslyn E.R. MPH, MPIA, PhD; Sterkel, Amanda PhD; Johnson, Dayna A. PhD, MPH, MS; Johnson-Lawrence, Vicki PhD

doi: 10.1097/PSY.0000000000000428

Objective Evidence suggests that sleep quality is worse in nonwhite minorities compared with whites. Poor sleep is associated with higher levels of perceived interpersonal discrimination, which is consistently reported among minorities. However, the literature is limited in exploring discrimination with both objective and subjective sleep outcomes in the same sample. We examined the relationship between discrimination and markers of subjective and objective sleep in a racially diverse sample.

Methods The analytic sample included 441 participants of the Midlife in the United States II (MIDUS) study (M [SD] age, 46.6 [1.03]; female, 57.9%; male, 42.1%; nonwhite, 31.7%). Complete data were available for 361 participants. Sleep measures included the Pittsburgh Sleep Quality Index, sleep latency, wake after sleep onset, and sleep efficiency derived from 7-day actigraphy. Discrimination was measured with the Williams Everyday Discrimination Scale. Ordinary least squares and logistic regression models were used to assess the relationship between discrimination and the subjective and objective measures of sleep.

Results After adjusting for covariates, respondents with higher discrimination scores were significantly more likely to experience poor sleep efficiency (odds ratio, 1.12; p = .005) and report poorer sleep quality (odds ratio, 1.09; p = .029) on the basis of the Pittsburgh Sleep Quality Index. Higher discrimination scores were also associated with longer wake after sleep onset (b = 0.032, p < .01) and more sleep difficulties (b = 0.049, p = .01). Discrimination attenuated all differences in the sleep measures between whites and nonwhites except for sleep efficiency.

Conclusions The findings support the model that discrimination acts as a stressor that can disrupt subjective and objective sleep. These results suggest that interpersonal discrimination explains some variance in worse sleep among nonwhites compared with whites.

From the Department of Social and Behavioral Sciences (Owens, Hunte), West Virginia University, Morgantown, West Virginia; Department of Psychiatry and Behavioral Sciences (Sterkel), Stanford University, Stanford, California; Division of Sleep Medicine (Johnson), Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts; and Department of Public Health and Health Sciences (Johnson-Lawrence), University of Michigan-Flint, Flint, Michigan.

Address correspondence and reprint requests to Sherry L. Owens, PhD, School of Public Health, Department of Social and Behavioral Sciences, West Virginia University, 1 Medical Center Dr, P.O. Box 9190, Morgantown, WV 26506. E-mail:

Received for publication April 8, 2016; revision received October 4, 2016.

Copyright © 2017 by American Psychosomatic Society
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