0836 The Association Between Discrimination and Sleep is Exacerbated in Individuals with Comorbid Chronic Health Conditions

• Published in: Sleep (New York, N.Y.) N.Y.), 2019-04, Vol.42 (Supplement_1), p.A335-A336
• Main Authors: Ghose, Sarah M, Dautovich, Natalie D, Dzierzewski, Joseph M, Sabet, Sahar M, Imel, Janna L, Schreiber, Dana R, MacPherson, Ashley R, Reid, Morgan P
• Format: Article
• Language: English
• Subjects: Chronic illnesses; Comorbidity; Hardship; Perceptions; Sleep
• ISSN: 0161-8105; 1550-9109
• DOI: 10.1093/sleep/zsz067.834

Introduction The consequences of recurrent and stressful daily experiences for sleep health appear to be particularly intensified in individuals with pre-existing health conditions. Although experiences of discrimination have been associated with sleep outcomes, the exacerbating role of chronic comorbid health conditions, and the impact of perceptions of discrimination, remains unclear. The present study investigated the associations between daily discrimination and subjective and objective sleep outcomes while examining the moderating roles of comorbid health conditions and perceived daily life interference and hardship. Methods The current study utilized archival data from the Midlife in the United States (MIDUS) Study II. Participants were 174 adults (51% female, Mage=57 yrs., SD=11.5 yrs.) who completed 7 days of actigraphy, sleep diary measures, the PSQI, and a measure quantifying individuals' number of chronic health conditions. Age and gender were covariates. Models examined the moderating effects of number of comorbidities, daily life interferences, and hardship on the association between discrimination and sleep outcomes. Results Daily experiences of discrimination predicted a variety of poor objective and subjective sleep outcomes. These associations were exacerbated for persons with higher numbers of comorbid conditions. Higher chronic disease comorbidity (95% CI=5.40, 68.75) exacerbated the association between daily discrimination and TSTactigraphy. This moderation was further strengthened by perceived hardship (95% CI=-3.75, -.40) and interference (95% CI=-3.65, -.30). Further, number of comorbid conditions, qualified by perceived hardship (95% CI=.00, .04) and interference (95% CI=.01, .05), predicted diary sleep quality above discrimination alone. The interaction between comorbid conditions and hardship also predicted global quality PSQI scores (95% CI=-.91, -.12) beyond discrimination. Conclusion Daily experiences of discrimination are associated with shorter objectively-measured sleep duration and worse subjectively-assessed sleep quality. These associations were stronger for individuals with multiple chronic comorbid health conditions. The exacerbating effects of health conditions were further perpetuated by perceptions of interference and hardships, suggesting the presence of individual differences in emotion regulation strategies. Future research should explore how, and by which mechanisms, differential responding toward discrimination