Yale School of Nursing, Orange, Connecticut, USA.
University of Connecticut School of Nursing, Storrs, Connecticut, USA.
Sleep Health. 2022 Jun;8(3):334-345. doi: 10.1016/j.sleh.2022.03.004. Epub 2022 Apr 30.
Sleep deficiency and sleep disorders disproportionally affect socially disadvantaged and marginalized individuals and groups. Recent evidence suggests that stigma, a social process characterized by labeling, stereotyping, and prejudice, is associated with sleep characteristics.
Guided by the Health Stigma and Discrimination Framework, the purpose of this systematic review is to describe associations between dimensions of stigma and sleep deficiency and to identify future directions for research.
We searched the OVIDPsycINFO, OVIDEMASE, OVIDMEDLINE, and CINAHL databases for empirical research studies that reported relationships between the 3 dimensions of stigma-internalized, perceived, and anticipated-and characteristics of sleep deficiency-duration, continuity/efficiency, timing, alertness/sleepiness, quality, and disorders.
Of 1717 articles, 15 met our inclusion criteria. The most frequently assessed dimensions of stigma were internalized and perceived stigma. Characteristics of sleep deficiency were measured by self-report and included sleep quality, duration, trouble sleeping, and insomnia symptoms. We found consistent evidence that stigma, whether internalized, perceived, or anticipated, is associated with self-reported characteristics of sleep deficiency.
This evidence base can be further strengthened with prospective studies that incorporate both multidimensional measures of stigma and objective measures of sleep characteristics. We outline research implications that can clarify underlying mechanisms and more precisely define the relationships between stigma and sleep and inform interventions to address stigma, improve sleep, and reduce the health inequities that disproportionately affect individuals from socially disadvantaged and marginalized groups.
睡眠不足和睡眠障碍不成比例地影响社会劣势和边缘化的个人和群体。最近的证据表明，污名化是一种以贴标签、刻板印象和偏见为特征的社会过程，与睡眠特征有关。
本系统评价以健康污名和歧视框架为指导，旨在描述污名的三个维度（内化、感知和预期）与睡眠不足的特征之间的关联，并确定未来的研究方向。
我们在 OVIDPsycINFO、OVIDEMASE、OVIDMEDLINE 和 CINAHL 数据库中搜索了报告 3 个维度（内化、感知和预期）与睡眠不足（持续时间、连续性/效率、时间、警觉/嗜睡、质量和障碍）特征之间关系的实证研究。
在 1717 篇文章中，有 15 篇符合我们的纳入标准。最常评估的污名维度是内化和感知污名。睡眠不足的特征通过自我报告来衡量，包括睡眠质量、持续时间、睡眠困难和失眠症状。我们发现有一致的证据表明，污名，无论是内化的、感知的还是预期的，都与自我报告的睡眠不足特征有关。
通过纳入多维污名测量和客观睡眠特征测量的前瞻性研究，可以进一步加强这一证据基础。我们概述了研究意义，可以阐明潜在机制，并更准确地定义污名与睡眠之间的关系，并为解决污名、改善睡眠以及减少不成比例地影响社会劣势和边缘化群体的个人的健康不平等问题提供干预措施。
