Sleep problems among sexual minorities: a longitudinal study on the influence of the family of origin and chosen family

Antony Chum,Celine Teo,Andrew Nielsen

doi:10.1186/s12889-021-12308-0

Antony Chum, Celine Teo + Show 1 more

Open Access

https://doi.org/10.1186/s12889-021-12308-0

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Abstract

BackgroundThere is growing evidence that lesbian, gay, and bisexual (LGB) adults experience more sleep problems than the general population. As LGB individuals experience a significantly greater risk of family rejection and low family support, our study investigates the role of family support as a potential determinant of LGB sleep problems over a prolonged period, and whether friend support (i.e. chosen family) can mitigate the effect of low family support. Given the importance of sleep on mental and physical health, study results may help shed light on persistent health disparities across sexual orientations.MethodsOur sample included 1703 LGB individuals from the UK Household Longitudinal Study (UKHLS). Mixed-effect logistic regressions were used to estimate the effect of family and friend support on the development of sleep problems after 24 months while controlling for potential confounders. A modified Pittsburgh Sleep Quality Index was used to measure 1) presence of any sleep problems, 2) short sleep duration, and 3) poor sleep quality.ResultsFamily support at baseline was independently associated with all sleep problems in our study after 24-months: 1 SD increase in family support was associated with a 0.94 times lower risk of sleep problems (95% C.I = 0.90-0.98), a 0.88 times lower risk of short sleep duration (95% C.I = 0.81-0.95), and a 0.92 times lower risk of sleep quality (95% C.I = 0.93-0.98). Support from one’s chosen family (proxied by friend support) did not mitigate the effects of low family support on sleep problems.ConclusionsOur study found a consistent effect of family support across all sleep outcomes along with evidence of a persistent effect after 24 months. Our findings point to the importance of targeting family support in designing interventions aimed at reducing LGB sleep problems.

Highlights

There is growing evidence that lesbian, gay, and bisexual (LGB) adults experience more sleep problems than the general population
While neighbourhood cohesion was not the main focus of this study, we found that a onepoint increase in neighbourhood cohesion was associated with 0.82 times lower risk of short sleep duration, and 0.88 times lower risk of poor sleep quality
The importance of family support on sleep problems Our study provides evidence that family support has a prolonged effect on the sleep problems of sexual minorities, where higher levels of family support were associated with reductions in the risk of sleep dysfunction, short sleep duration, and poor sleep quality

Summary

Introduction

There is growing evidence that lesbian, gay, and bisexual (LGB) adults experience more sleep problems than the general population. Previous studies among youth provide evidence that family support has a critical role in shaping early LGB identity development [12, 13] with sustained effects on mental wellbeing throughout one’s adulthood [5]. These studies highlight the importance of family as a locus of LGB minority stress, which in turn can impact LGB sleep outcomes [14]. Given that sleep problems are associated with cardiovascular disease [15], anxiety and depression [16], type-2 diabetes [17], and all-cause mortality [17], investigating the effects of family support on LGB sleep problems may help us better understand the determinants of persistent mental and physical health disparities across sexual orientations [18, 19]

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