title: Chronic exposure to everyday discrimination and sleep in a multiethnic sample of middle-aged women.
abstract: OBJECTIVE
  Researchers have suggested that poor sleep may play a role in the association between discrimination and health, but studies linking experiences of discrimination to sleep are limited. The authors examined associations between reports of everyday discrimination over 4 years (chronic everyday discrimination) and subjective and objective indicators of poor sleep.
  
  
  METHODS
  Participants were 368 African American, Caucasian, and Chinese women from the Study of Women's Health Across the Nation Sleep Study. Everyday discrimination was assessed each year from baseline through the third follow-up exam via questionnaire with the Everyday Discrimination Scale (intraclass correlation coefficient over 4 years = .90). Subjective sleep complaints were measured beginning in Year 5 with the Pittsburgh Sleep Quality Index. Objective indices of sleep continuity, duration, and architecture were assessed via in-home polysomnography, beginning in Year 5.
  
  
  RESULTS
  In linear regression analyses adjusted for age, race/ethnicity, and financial strain, chronic everyday discrimination was associated with more subjective sleep complaints (Estimate = 1.52, p < .001) and polysomnography-assessed wakefulness after sleep onset (Estimate = .19, p < .02), a marker of sleep continuity. Findings did not differ by race/ethnicity and remained significant after adjusting for menopausal status, body mass index, medication use, and depressive symptoms.
  
  
  CONCLUSIONS
  Experiences of chronic everyday discrimination are independently associated with both subjective and objective indices of poor sleep. Findings add to the growing literature linking discrimination to key markers of biobehavioral health.
authors.affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322 , USA. tene.t.lewis@emory.edu
authors.forename: Tené T
authors.initials: TT
authors.lastname: Lewis
authors.forename: Wendy M
authors.initials: WM
authors.lastname: Troxel
authors.forename: Howard M
authors.initials: HM
authors.lastname: Kravitz
authors.forename: Joyce T
authors.initials: JT
authors.lastname: Bromberger
authors.forename: Karen A
authors.initials: KA
authors.lastname: Matthews
authors.forename: Martica H
authors.initials: MH
authors.lastname: Hall
mesh_terms: D001741:Black or African American / Q000523:psychology*; D044466:Asian People / Q000523:psychology*; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D017286:Polysomnography; D011287:Prejudice / Q000208:ethnology* / Q000706:statistics & numerical data; D007319:Sleep Initiation and Maintenance Disorders / Q000208:ethnology*; D013315:Stress, Psychological / Q000208:ethnology / Q000523:psychology; D011795:Surveys and Questionnaires; D013997:Time Factors; D014851:Wakefulness; D044465:White People / Q000523:psychology*