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Published Online: 27 June 2023

Sexual Orientation Disparities in Early Adolescent Sleep: Findings from the Adolescent Brain Cognitive Development Study

Publication: LGBT Health
Volume 10, Issue Number 5


Purpose: The purpose of this study was to examine associations between sexual minority status (e.g., gay or bisexual) and sleep problems in a demographically diverse, national sample of U.S. early adolescents.
Methods: We analyzed cross-sectional data from the Adolescent Brain Cognitive Development Study (Year 2, 2018–2020) to estimate associations between sexual orientation and sleep problems or disturbance, adjusting for confounders and testing potential mediators (depressive problems, stress problems, family conflict, and parental monitoring).
Results: In a sample of 8563 adolescents 10- to 14-years-old, 4.4% identified as sexual minority individuals. Sexual minority status was associated with self-reported trouble falling or staying asleep (risk ratio [RR] = 2.24, 95% confidence interval [CI] = 1.88–2.68) and caregiver-reported sleep disturbance (RR = 1.50, 95% CI = 1.29–1.75). The association between sexual minority status and trouble falling or staying asleep was partially mediated by greater depressive problems, more family conflict, and less parental monitoring, whereas the association between sexual minority status and caregiver-reported sleep disturbance was partially mediated by greater depressive problems, higher stress, and greater family conflict.
Conclusions: Our results indicate that sexual minority status may be linked to sleep disturbance in early adolescence. Depressive problems, stress, family conflict, and less parental monitoring partially mediate disparities in sleep health for sexual minority youth. Future research could test interventions to promote family and caregiver acceptance and mental health support for sexual minority youth to improve their sleep and other health outcomes.

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The funders had no role in the study analysis, decision to publish the study, or the preparation of the article.


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Information & Authors


Published In

cover image LGBT Health
LGBT Health
Volume 10Issue Number 5July 2023
Pages: 355 - 362
PubMed: 36944127


Published in print: July 2023
Published online: 27 June 2023
Published ahead of print: 21 March 2023


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Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA.
Christopher M. Lee
Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA.
Joanne H. Yang
Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA.
Orsolya Kiss
Center for Health Sciences, SRI International, Menlo Park, California, USA.
Kyle T. Ganson
Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.
Alexander Testa
Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, Texas, USA.
Dylan B. Jackson
Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
Abubakr A.A. Al-shoaibi
Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, San Francisco, California, USA.
Fiona C. Baker
Center for Health Sciences, SRI International, Menlo Park, California, USA.
School of Physiology, University of the Witwatersrand, Johannesburg, South Africa.


Address correspondence to: Jason M. Nagata, MD, MSc, Division of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, San Francisco, 550 16th Street, 4th Floor, Box 0503, San Francisco, CA 94143, USA [email protected]

Authors' Contributions

J.M.N.: Conceptualization; writing—original draft and reviewing; formal analysis; supervision. C.M.L.: writing—original draft, review, and editing. J.H.Y.: Data analysis; writing—original draft, review, and editing. O.K., K.T.G., A.T., D.B.J.: writing—review, and editing. A.A.A.A.-s.: Data analysis; writing—review and editing. F.C.B.: Conceptualization; methodology; writing—review and editing.

Author Disclosure Statement

The authors have no conflict to declare.

Funding Information

J.M.N. was supported by the National Institutes of Health (K08HL159350) and the Doris Duke Charitable Foundation (2022056).

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