University of Colorado, Boulder, CO, USA.
University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Ann Behav Med. 2022 Aug 30;56(9):969-976. doi: 10.1093/abm/kaab097.
Sleep impairment may be a key pathway through which discrimination undermines health. Links between discrimination and sleep in American Indians and Alaska Natives (AI/AN) have not been established. Further, it is unclear if such links might depend on the timing of discrimination or if socioeconomic status (SES) might buffer the impact of discrimination.
To investigate associations between interpersonal discrimination and sleep impairment in urban AI/AN, for both lifetime and recent discrimination, and controlling for other life stressors. Education and income, indices of SES, were tested as potential moderators.
A community sample of urban AI/AN (N = 303, 18-78 years old, 63% female) completed self-report measures of sleep impairment, lifetime and recent discrimination, depressive symptoms, perceived stress, other life stressors (childhood adversity and past year major events), and socio-demographic characteristics.
Lifetime discrimination was associated with impaired sleep in AI/AN after adjustment for socio-demographic characteristics, recent depressive symptoms, perceived stress, and other life stressors. Past-week discrimination was associated with sleep in unadjusted but not adjusted models. Education, but not income, was found to buffer the effects of both lifetime and past-week discrimination on sleep in adjusted models.
Lifetime discrimination uniquely accounts for sleep impairment and may be especially harmful in those with less education. These findings suggest targeting interventions to those most in need. Limitations include the cross-sectional nature of the data. Longitudinal and qualitative work is needed to understand how education may buffer the effects of discrimination on sleep and perhaps other health problems in AI/AN.
睡眠障碍可能是歧视损害健康的关键途径。在美国印第安人和阿拉斯加原住民（AI/AN）中，歧视与睡眠之间的联系尚未建立。此外，尚不清楚这种联系是否取决于歧视的时间，或者社会经济地位（SES）是否可以缓冲歧视的影响。
调查城市 AI/AN 中人际歧视与睡眠障碍之间的关联，包括终生和近期歧视，并控制其他生活应激源。教育和收入，SES 的指标，被测试为潜在的调节因素。
一项城市 AI/AN 的社区样本（N = 303，年龄 18-78 岁，63%为女性）完成了睡眠障碍、终生和近期歧视、抑郁症状、感知压力、其他生活应激源（儿童期逆境和过去一年的重大事件）以及社会人口统计学特征的自我报告测量。
在调整社会人口统计学特征、近期抑郁症状、感知压力和其他生活应激源后，终生歧视与 AI/AN 的睡眠障碍相关。过去一周的歧视与未经调整的睡眠相关，但在调整后的模型中则没有。发现教育，而不是收入，缓冲了调整后模型中终生和过去一周歧视对睡眠的影响。
终生歧视是睡眠障碍的唯一原因，在受教育程度较低的人群中可能更为有害。这些发现表明需要针对最需要的人群开展干预措施。研究的局限性包括数据的横断面性质。需要进行纵向和定性研究，以了解教育如何缓冲歧视对睡眠和 AI/AN 中其他健康问题的影响。
