535 Associations between Multiple Stressors (Including Racism) and Sleep Health among Young African-American Women

Abstract Introduction Stress contributes to poor sleep, and both are associated with adverse mental and physical health outcomes. African-American women are disproportionately burdened by multiple forms of stress as well as poor sleep, but few studies have investigated the stressor-sleep relationship in this population. Methods We investigated associations between multiple measures of both stressors and sleep among African American women participating in the Study of Environment, Lifestyle and Fibroids. Using principal components analysis, we summarized 43 items ascertaining self-reported stressors (e.g., racism) and potential mitigators (e.g., resilience). Components were extracted and factor scores generated. Self-reported sleep included short (<7 hours) versus recommended (7–9 hours) sleep, waking unrested 4+ days/week, and insomnia symptoms (>4 nights per month). Adjusting for demographics, health behaviors, and body mass index, we used Poisson regression with robust variance to estimate prevalence ratios (PRs) for each factor score dichotomized at the median. Results Among 1,672 women, mean age was 29.2 ± 3.4 years and 45% had a household income <$20,000. We extracted 9 stress factors accounting for 57% of the variance across the 43 items. In order of contribution to explaining the variance, stress factors included emotional distress (e.g., frequency of anger suppression and rumination); racism; social/emotional support; financial strain; medical/crime/family problems; faith/spirituality; resilience; job/home changes; and intimate partner changes/problems. Emotional distress (PR=1.52 [1.35–1.72]), racism (PR=1.28 [1.13, 1.44]), and financial strain (PR=1.14 [1.01–1.29]) were associated with insomnia symptoms. Emotional distress was also related to waking unrested (PR=1.36 [1.26–1.47]) while social/emotional support (PR=0.85 [0.79–0.92]) and resilience (PR=0.88 [0.82–0.95]) were protective. Short sleep was associated with a higher prevalence of emotional distress (PR=1.15 [1.06–1.25]) as well as medical/crime/family problems (PR=1.21 [1.03–1.42]); however, there was a protective association between resilience and short sleep (PR=0.88 [0.82–0.96]). Conclusion Multiple stressors were associated with sleep disturbances, but social/emotional support and resilience were associated with more favorable sleep. Support (if any):