The effects of sexual orientation and adverse childhood experiences on short sleep duration: Evidence from the behavioral risk factor surveillance system (BRFSS)

Abstract

Background

Adverse childhood experiences (ACEs) are associated with an increased risk of short sleep duration in adulthood. This study aims to explore the relationship between sexual orientation, ACEs and short sleep duration.

Methods

61,323 adults from the Behavioral Risk Factor Surveillance System (BRFSS) were included in this study. We measured sexual orientation, ACEs and short sleep duration with participants' self-report. Multivariate logistic regression analysing the effects of sexual orientation, ACEs and their interactions on short sleep duration.

Results

More sexual minoritized individuals reported short sleep duration compared to heterosexual individuals (32.10 % for heterosexuals; 33.70 % for sexual minoritized individuals). More sexual minoritized individuals reported being exposed to >1 ACE (heterosexual = 62.8 %; sexual minoritized individuals = 82.2 %. P < 0.001) than heterosexuals, especially sexual minorities are about three times more likely than heterosexual to be sexually abused (heterosexual = 11.1 %; sexual minoritized individuals = 31.2 %, P < 0.001). More bisexual women reported sexual abuse than bisexual men (38.2 % for bisexual women; 22.6 % for bisexal men). Positive association between ACEs status and short sleep duration (OR:2.23, 95%CI: 1.36,3.65) was identified among sexual minoritized individuals. Those sexual minorities individuals who experienced sexual abuse in childhood, emotional abuse, and mental illness in the household had 1.72, 1.38, and 1.39 times the risk of having a short sleep duration in adulthood as compared to heterosexual household, respectively. Moreover, there was a significant interaction between sexual abuse and sexual orientation.

Limitations

The cross-sectional design limited the ability to make causal inference.

Conclusion

This study shows that sexual abuse experiences suffered by sexual minority adults during childhood may lead to a higher risk of subsequent short sleep duration as well. Thus, the risk of short sleep duration in sexual minorities is reduced by reducing the occurrence of ACEs.