Abstract

Sexual minority adolescents have worse sleep health than their peers. Adolescents who identify as heterosexual and report prior same-sex sexual contact (termed ‘discordant heterosexuals’) have elevated health risks, but little is known about this group’s sleep health. This study examined 2015–2017 Youth Risk Behavior Survey data (n = 12,773 high school students) comparing discordant heterosexuals to their concordant (i.e. sexual identity is concordant with reported sex of sexual contact) heterosexual, bisexual, gay and lesbian peers on three sleep outcomes: sufficient (≥8 hours), short (≤6 hours) and extremely limited sleep (≤4 hours). Both discordant heterosexual (aOR:0.64, 95% CI:0.47, 0.86) and bisexual students (aOR:0.69, CI:0.56, 0.85) had lower odds of sufficient sleep compared to concordant heterosexuals, even after adjustment for demographic factors and substance use. Discordant heterosexual (aOR:1.29, CI:1.01, 1.66) and bisexual (aOR:1.74, CI:1.54, 1.98) students have higher odds of short sleep. Discordant heterosexual (aOR:1.94, CI:1.36, 2.77) and bisexual students (aOR:2.72, CI:2.23, 3.31) also had higher odds of extremely limited sleep. Victimization may partially explain some of these associations. Sleep health is one factor that may drive health disparities, and efforts to ensure that adolescents are safe and secure in sexual behavior and identity is important to reducing these disparities.

摘要

性少数青少年的睡眠健康状况比同龄人差。认定为异性恋并报告之前有过同性性接触的青少年（称为“不和谐的异性恋”）的健康风险较高，但对该群体的睡眠健康知之甚少。本研究考察了 2015-2017 年青年风险行为调查数据（n = 12,773 名高中生）将不和谐的异性恋者与他们的一致（即性身份与报告的性接触性别一致）异性恋、双性恋、男同性恋和女同性恋同伴的三种睡眠结果进行比较：充足（≥8 小时）、短（≤6 小时） ) 和极其有限的睡眠（≤4 小时）。与一致的异性恋者相比，不一致的异性恋者 (aOR:0.64, 95% CI:0.47, 0.86) 和双性恋学生 (aOR:0.69, CI:0.56, 0.85) 睡眠充足的几率较低，即使在调整了人口因素和物质使用后也是如此. 不和谐的异性恋（aOR:1.29, CI:1.01, 1.66）和双性恋（aOR:1.74, CI:1.54, 1.98）学生睡眠时间短的几率更高。不和谐的异性恋（aOR：1.94，CI：1.36，2.77）和双性恋学生（aOR：2.72，CI：2.23，3.31）也有更高的睡眠极度受限的几率。受害可能部分解释了其中一些关联。睡眠健康是可能导致健康差异的一个因素，确保青少年在性行为和身份方面安全可靠的努力对于缩小这些差异非常重要。