Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA.
Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA.
Addict Behav. 2023 Feb;137:107506. doi: 10.1016/j.addbeh.2022.107506. Epub 2022 Sep 30.
Insomnia is a common sleep disorder associated with poor health outcomes. Individuals from racially underrepresented groups as well as women tend to report more severe insomnia symptoms, and frequent experiences of discrimination have been found to drive such disparities. Smokers commonly experience sleep problems since nicotine can alter the sleep-wake cycle. Discrimination is associated with increased nicotine dependence, and such discrimination may also intensify tobacco withdrawal, specifically mood and cognitive-related aspects of withdrawal. The potential impact of discrimination on withdrawal symptoms and related mood symptoms like depression may lead to increases in insomnia symptoms. However, no studies to date have evaluated the indirect association of discrimination with insomnia severity through nicotine withdrawal and depressive symptoms. Therefore, this cross-sectional survey of n = 110 non-Hispanic Black and White current smokers (48.2 % Black, 69.1 % women) investigated these associations through a serial mediation model. Controlling for race, gender, nicotine dependence levels, and income, multivariate analyses supported a significant indirect effect of discrimination on insomnia severity through depressive symptoms. Analyses supported the hypothesized serial mediation model whereby discrimination is positively associated with depressive symptoms, which in turn are linked to more severe nicotine withdrawal, leading to greater insomnia severity. Smokers encountering frequent experiences of discrimination might be at increased risk of suffering insomnia as a result of their increased depressive and withdrawal symptoms. Future work is necessary to understand the role of depressive symptoms in these associations as well as possible implications for smoking relapse and success of smoking cessation programs.
失眠是一种常见的睡眠障碍，与健康状况不佳有关。来自代表性不足的少数族裔群体的个体以及女性往往报告更严重的失眠症状，并且已经发现频繁的歧视经历是造成这种差异的原因。由于尼古丁会改变睡眠-觉醒周期，吸烟者通常会出现睡眠问题。歧视与尼古丁依赖增加有关，这种歧视也可能加剧烟草戒断，特别是与戒断相关的情绪和认知方面。歧视对戒断症状和相关情绪症状（如抑郁）的潜在影响可能导致失眠症状加重。然而，迄今为止，尚无研究评估歧视通过尼古丁戒断和抑郁症状对失眠严重程度的间接关联。因此，本横断面调查研究了 n = 110 名非西班牙裔黑人和白人当前吸烟者（48.2%为黑人，69.1%为女性），通过序列中介模型研究了这些关联。在控制种族、性别、尼古丁依赖程度和收入后，多变量分析支持歧视通过抑郁症状对失眠严重程度的显著间接影响。分析支持假设的序列中介模型，即歧视与抑郁症状呈正相关，抑郁症状又与更严重的尼古丁戒断有关，从而导致更严重的失眠。经常遇到歧视的吸烟者可能由于抑郁和戒断症状增加而面临更高的失眠风险。未来的工作需要了解抑郁症状在这些关联中的作用，以及对吸烟复发和戒烟计划成功的可能影响。
