Sleep in gay, lesbian and bisexual individuals: The roles of minority stressors and identity positivity

Objectives: Although there are increasing reports suggesting that sexual minorities sleep badly, very few empirical studies have used standard sleep measures. Moreover previous studies have not considered the ways in which different identities and identity processes may interact with sleep.

Methods: We addressed this in an on-line sample of almost 300 self-identified lesbian women (N = 40), gay men (N = 55) and bisexual men (N = 87) and bisexual women (N = 118). We assessed sleep using the Pittsburgh Sleep Quality Index, Insomnia Severity Index and Epworth Sleepiness Scale, among others; wellbeing using measures of life satisfaction, anxiety and depression, and lesbian, gay and bisexual (LGB) identification, social support, discrimination, identity resilience and minority stressors.

Results: All sleep measures suggested that sexual minorities sleep poorly, and experience identity challenges, minority stressors, high levels of anxiety and depression and reduced life satisfaction. The latter wellbeing variables and BMI account for substantial amounts of variance in scores on standard sleep measures, as do identity and minority stressors. These variables mediate each other such that a confident sexual identity is associated with reduced effects of minority stressors on sleep, and enhanced wellbeing and sleep. There were no differences between LGB subgroups in these effects, except for insomnia, which was worse in bisexuals than in lesbian and gay individuals.

Conclusions: Standard self-report measures of sleep confirm that sexual minorities sleep poorly, and identification with or stresses due to minority status exascerbates this.