Inequalities in Late Adolescents’ Sleep Quality During the COVID-19 Pandemic

• In Event: Sleep During the COVID-19 Pandemic: Evidence Among Youth, Adolescents, and Parents

Abstract

Aim: The COVID-19 pandemic greatly disrupted the daily lives of college-going youth across the United States. Though most adolescents are relatively unaffected by symptoms of COVID-19, prior studies suggest that large-scale social stressors can result in poorer sleep quality (Benham, 2020). Furthermore, poorer sleep health sleep is more commonly reported among youth who face marginalization (Patterson et al., 2018). This paper seeks to document sleep inequalities by gender identity, sexual orientation, race/ethnicity, and socioeconomic position (SEP) in a diverse sample of late adolescent full-time college students across the United States.
Methods: Late adolescents aged 18-22 (N = 707; Mage= 20.0, SD = 1.3) were recruited via Instagram to participate in an online survey in April 2020 (baseline). Participants attended 374 different colleges and were diverse in terms of race, gender, sex, and SEP (see Table 1). The Pittsburgh Sleep Quality Index (PSQI) was used to measure seven components of sleep: quality, latency, duration, efficiency, duration, use of sleep medication, and daytime dysfunction. A follow-up study was conducted in July and August of 2021, with 44.3% of participants completing it (n = 313). The researchers conducted multivariable multiple regression and logistic regression models to examine group differences in sleep.
Results: Most participants reported poor overall sleep quality at both time points (78% and 82% at baseline and follow-up, respectively). At baseline, women, transgender and gender diverse (TGD), LGBQ+ (i.e., non-heterosexual), and lower-SEP youth reported worse sleep quality than their counterparts. At follow-up, LGBQ+, TGD, and lower-SEP individuals continued to report poorer sleep than their peers, even after accounting for baseline measures of sleep quality. One notable difference is that students who identified as Asian-American Pacific Islanders (AAPI) seemed to have worse sleep quality in 2021 compared to 2020 (see Table 2).
Conclusions: Researchers should continue to monitor the presence of sleep inequalities affecting marginalized youth during the COVID-19 pandemic. Two particular groups to pay attention to are AAPI individuals and LGBQ+ youth, which dealt with discrimination and racism in addition to the main stressors of the COVID-19 pandemic (Wang et al., 2020; Harry-Hernandez et al., 2020). Over 60.7% of AAPI individuals reported discrimination during the pandemic, which may contribute to poorer sleep quality (Park et al., 2022). Lockdown may have sent LGBQ+ and TGD students back to households that were unaware or unsupportive of their identities, resulting in a poorer sleep environment (Patterson et al., 2018). Similarly, low-SEP students may have returned to environments that were not conducive to sleep in addition to increased financial stress (Peltz et al., 2020). Continued environmental stress and a lack of social support may be one reason why sleep inequalities emerge in marginalized youth. Clinicians and public health professionals need to focus attention on youth from minoritized backgrounds, who may have undergone some of the more challenging aspects of the pandemic. Colleges can also work to reduce sleep inequalities among their students by placing specialized resources targeted at students with LGBQ+, AAPI identities, or low-SEP backgrounds.

Authors

• Ayurda Pathak, Fordham University
  Presenting Author

• Neshat Yazdani

• Lindsay Till Hoyt, Fordham University

• Alison Cohen