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Racial Disparities in Sleep: Potential Mediation by Discrimination and Psychological Distress

Abstract

Previous research has demonstrated that experiences of discrimination contribute to racial disparities in sleep, and that psychological distress mediates these relationships. However, previous research has not included race as part of the mediation pathway and has had limited dimensions of sleep health and psychological mediators. In the current study, we examine serial mediation pathways by which race and sleep health are mediated through discrimination and subsequently through psychological distress (i.e., depressive symptoms, chronic stress, and loneliness). Data were from the 2010 wave of the Health Retirement Study (HRS). The analytic sample (n = 7,749) included Black and White participants who were included in the enhanced face-to-face interview in 2010 and who completed the psychosocial questionnaire. Race was reported as either Black or White. Sleep health was assessed with a 4-item questionnaire. Depressive symptoms were assessed with the shortened CES-D, chronic stress via the ongoing chronic stressor scale, and loneliness via the UCLA loneliness scale. Covariates were included in all serial mediation models. Relative to White participants, Black participants reported increased experiences of discrimination, which was associated with increased psychological distress, and poorer sleep health. Findings demonstrate the significant adverse impact that discrimination has on both psychological well-being and sleep health.

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Data Availability

Study data and materials are publicly available on the HRS website.

Code Availability

Code is available upon request.

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Funding

Research reported in this publication was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health T32HL007909, T32HL069771, R01HL141881, and R01AG059291.

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Authors

Contributions

MPM, EAV, and KLK were all contributed to manuscript development. MPM and EAV conducted statistical analyses and wrote initial draft of manuscript. KLK provided substantial feedback on revisions of the manuscript.

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Correspondence to Michael P. Mead.

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Ethics Approval

The HRS study was granted approval from the institutional review board (IRB) at the University of Michigan.

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Participants provided consent to participate.

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All authors consent to have this manuscript submitted for publication.

Conflict of Interest

Dr. Knutson reports grants from NIH during the conduct of the study, personal fees from Sleep Research Society Foundation, and personal fees from Onecare Media, outside the submitted work.

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Mead, M.P., Vargas, E.A. & Knutson, K.L. Racial Disparities in Sleep: Potential Mediation by Discrimination and Psychological Distress. J. Racial and Ethnic Health Disparities 10, 573–580 (2023). https://doi.org/10.1007/s40615-022-01247-0

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  • DOI: https://doi.org/10.1007/s40615-022-01247-0

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