# Psychosocial and Behavioral Correlates of Sleep Duration and Sleep Disturbance Among Lesbian, Gay, and Bisexual Women

## TL;DR

This study finds that psychosocial factors like social strain and optimism are linked to sleep issues in lesbian, gay, and bisexual women, suggesting new approaches for improving their sleep.

## Contribution

The study identifies specific psychosocial factors uniquely associated with sleep outcomes in LGB women, which could inform targeted interventions.

## Key findings

- Social strain and negative emotional expressiveness are negatively associated with sleep outcomes in LGB women.
- Social function and optimism are positively associated with sleep outcomes in LGB women.
- Health behaviors like smoking and exercise are not significantly linked to sleep outcomes in LGB women.

## Abstract

Public health relevance—How does this work relate to a public health issue?
Lesbian, gay, and bisexual women experience inequities in sleep duration and disturbance when compared to heterosexual women, and solutions to improve this may include understanding the psychosocial factors that can be added to evidence-based behavioral interventions to improve sleep for LGB women. However, the most relevant psychosocial factors in sleep for LGB women have not yet been documented.Psychosocial characteristics were significantly associated with sleep outcomes for LGB women. Social strain and negative emotional expressiveness were negatively associated with sleep outcomes, while social function and optimism were positively associated with sleep outcomes. Health behaviors, including current smoking, alcohol consumption, and exercise, were not significantly associated with sleep outcomes for LGB women.

Lesbian, gay, and bisexual women experience inequities in sleep duration and disturbance when compared to heterosexual women, and solutions to improve this may include understanding the psychosocial factors that can be added to evidence-based behavioral interventions to improve sleep for LGB women. However, the most relevant psychosocial factors in sleep for LGB women have not yet been documented.

Psychosocial characteristics were significantly associated with sleep outcomes for LGB women. Social strain and negative emotional expressiveness were negatively associated with sleep outcomes, while social function and optimism were positively associated with sleep outcomes. Health behaviors, including current smoking, alcohol consumption, and exercise, were not significantly associated with sleep outcomes for LGB women.

Public health significance—Why is this work of significance to public health?
Sleep disturbance, insomnia, and shortened sleep as experienced by LGB women may be improved by implementing evidence-based interventions that include or address social strain, negative emotional expressiveness, and optimism. This is significant because sleep is a central pillar in women’s health, where quality sleep outcomes are associated with improvements in anxiety and depression as well as chronic disease—disease states that LGB women experience disproportionately higher than heterosexual women.

Sleep disturbance, insomnia, and shortened sleep as experienced by LGB women may be improved by implementing evidence-based interventions that include or address social strain, negative emotional expressiveness, and optimism. This is significant because sleep is a central pillar in women’s health, where quality sleep outcomes are associated with improvements in anxiety and depression as well as chronic disease—disease states that LGB women experience disproportionately higher than heterosexual women.

Public health implications—What are the key implications or messages for practitioners, policy makers, and/or researchers in public health?
Many sleep experts focus on health behaviors (e.g., tobacco use, alcohol, physical activity) to address sleep problems. Our findings suggest that this is an evidence-based approach for heterosexual women; however, among LGB women, psychosocial factors may be more relevant to sleep outcomes. Practitioners could consider sexual orientation and psychosocial experiences when engaging in solutions to address sleep. Researchers could begin to explore how to incorporate social strain, negative emotional expressiveness, social function, and optimism into evidence-based interventions for sleep improvement among LGB women.

Many sleep experts focus on health behaviors (e.g., tobacco use, alcohol, physical activity) to address sleep problems. Our findings suggest that this is an evidence-based approach for heterosexual women; however, among LGB women, psychosocial factors may be more relevant to sleep outcomes. Practitioners could consider sexual orientation and psychosocial experiences when engaging in solutions to address sleep. Researchers could begin to explore how to incorporate social strain, negative emotional expressiveness, social function, and optimism into evidence-based interventions for sleep improvement among LGB women.

Introduction: Sleep is an essential dimension of good physical and mental health. Lesbian, gay, and bisexual (LGB) women experience inequities in sleep duration and disturbance compared to heterosexual women. Psychosocial and behavioral characteristics are important to sleep in the general population; they may advance our understanding about sleep inequities among LGB women and provide key information for developing promising interventions. Methods: Data for this project were provided by the Women’s Health Initiative (WHI). The sample size for this project was 1436: 884 LG women and 552 bisexual women. Outcome variables were sleep duration and disturbance. The authors sought to clarify the associations, including the strength, between psychosocial factors and sleep outcomes among LGB women. Associations between psychosocial characteristics, health behaviors, and sleep outcomes were tested using multivariable, hierarchical, nested, linear regression models, stratified by sexual orientation. Results: Social strain, social function, optimism, and negative emotional expressiveness were significantly associated with sleep outcomes for LGB women. Health behaviors were not consistently or strongly associated with sleep outcomes for LGB women. Conclusions: The findings point to the importance of social strain, social function, negative emotional expressiveness, and optimism in LGB women’s sleep. It is possible that LGB women’s sleep could be improved with evidence-based interventions that use our findings.