Abstract 15871: Associations of Everyday Discrimination and Socioeconomic Status With Insomnia and Short Sleep Duration Among Older Women

Abstract

Introduction: Discrimination may contribute to sleep disparities, and subsequent adverse cardiovascular health. Despite the higher prevalence of insomnia among women, particularly historically minoritized women compared to men, limited studies examine the association between discrimination and insomnia and sleep duration. Methods: Among 26,616 women (Race/Ethnicity: Asian = 323; Black = 457; Hispanic= 258; White=25,287) in the Women’s Health Study stress follow-up cohort (Mean age =72.3 + 6.1 years), we investigated the relationship of discrimination with insomnia and sleep duration and tested education and income as effect modifiers. Insomnia was self-reported as trouble falling asleep OR waking after sleep onset 3+/week and daytime sleepiness 3+/week. Sleep duration was defined according to weekday and weekend bed and wake times, and categorized as short (<7 hours), recommended ( > 7 and <9 hours), and long ( > 9 hours). Everyday discrimination (e.g., treated with less courtesy or respect, received poorer service, etc.) frequency was divided into tertiles then dichotomized as high (upper tertile) and low (lower & middle tertile). Results: Insomnia, and short and long sleep duration were reported by 11%, 11%, and 15% of women, respectively, and high levels of discrimination were reported by 40% of women. There was a higher proportion of Asian and Black women who reported high discrimination compared to Hispanic and White women (53.2% and 57.3% vs 39.8% and 38.4%, respectively). Women reporting high vs. low discrimination were more likely to have insomnia and short sleep duration, but less likely to have long sleep [Insomnia Adjusted Prevalence Ratio (aPR): 1.33, 95% CI: 1.28-1.38; Short Sleep (aPR): 1.14, 95% CI:1.09-1.19; Long Sleep (aPR): 0.96, 95% CI: 0.95-0.97)]. Associations of discrimination with insomnia and short sleep duration were pronounced among Hispanic and White, but not Asian and Black women, and those of higher education ( > bachelors vs <bachelors) and income ( > $50,000 vs <$50,000). Conclusions: Discrimination may be a target for reducing the prevalence of insomnia and short sleep duration among women. Individuals of higher socioeconomic status may have increased vulnerability to the effects of discrimination on sleep.