Sexual Orientation and Sleep Behaviors in a National Sample of Adolescents Followed Into Young Adulthood

J Clin Sleep Med. 2019 Nov 15;15(11):1635-1643. doi: 10.5664/jcsm.8030.


Study objectives: Sexual minority adolescents experience mental and physical health disparities attributable to increased discrimination and minority stress. These same factors may also impair sleep health, although available literature on this topic is limited. This study examined longitudinal associations between adolescent sexual minority status and seven sleep behaviors in young adulthood and tested depressive symptoms and overweight as mediators.

Method: Data were drawn from Waves 2 (11th grade) to 7 (4 years after high school) of the NEXT Generation Health Study, a national longitudinal cohort study of US adolescents (n = 1946; 6.3% sexual minorities).

Results: There were no significant sexual orientation disparities in sleep duration, trouble falling asleep, trouble staying asleep, or trouble waking up during young adulthood. Relative to heterosexual females, sexual minority females had higher odds of snoring/stop breathing (36.6% versus 19.2%; adjusted odds ratio = 2.57; 95% confidence interval = 1.30, 5.09) and reported more frequent daytime sleepiness (b = 0.66, 95% confidence interval = 0.05, 1.27). Mediation analyses revealed that female sexual minority status was associated with increased risk of snoring/stop breathing though overweight status (mediated 43.6% of total effect) and was also associated with increased daytime sleepiness through higher depressive symptoms (mediated 70.8% of total effect).

Conclusions: Among US youth, no sexual orientation disparities were found except for snoring/stop breathing and daytime sleepiness among females. Sexual orientation disparities in these aspects of sleep are partially due to worse mental and physical health among sexual minority females, highlighting depressive symptoms and overweight problems as potential intervention targets.

Clinical trial registration: Registry:; Title: Health Behavior in School-Aged Children: NEXT Longitudinal Study 2009-2016; Identifier: NCT01031160.

Keywords: daytime sleepiness; depression; mediation; sexual orientation; sleep; snoring; weight.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Adolescent
  • Depression / epidemiology
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Pediatric Obesity / epidemiology
  • Pediatric Obesity / etiology
  • Risk Factors
  • Sexual and Gender Minorities / psychology
  • Sexual and Gender Minorities / statistics & numerical data*
  • Sleep Wake Disorders / epidemiology
  • Sleep Wake Disorders / etiology
  • Sleep*
  • United States / epidemiology
  • Young Adult

Associated data