Multiple psychosocial stressors and coping strategies in relation to sleep health

Abstract

Study Objectives To determine associations between multiple domains of psychosocial stressors and coping strategies in relation to sleep health among Black/African American (BAA) women. Methods Among 1678 BAA participants with complete data enrolled in the Study of Environment, Lifestyle and Fibroids, we conducted principal components analysis on 43 self-reported stressors, yielding six components of psychosocial stressors and three components of coping strategies. Self-reported sleep measures included sleep duration (very short, short, vs. recommended sleep), frequent insomnia symptoms (trouble falling or staying asleep at least 15 days/month vs. <15 days/month), and waking up feeling unrested (≥4 days/week vs. <4 days/week). Using Poisson regression with robust variance while adjusting for sociodemographic characteristics, we estimated prevalence ratios (PRs) and 95% confidence intervals (CIs) for each sleep measure comparing the presence vs. absence of stressors. Results Median age (interquartile range) was 29.3 (26.3–32.0) years and 45% had an annual household income of less than $20 000. The following psychosocial stressors were highly prevalent: perceived racism (84.5%), financial strain (84.1%), and emotional distress (73.7%). Emotional distress (PR = 2.26 [95% CI = 1.63 to 3.12]) and financial strain (PR = 1.41 [1.05–1.91]) were associated with more frequent insomnia symptoms. Social/emotional support (PR = 0.80 [0.68–0.95]) and resilience/personal strength (PR = 0.82 [0.70–0.97]) were associated with lower prevalence of very short sleep duration. BAA women reporting experiences with racism vs. not had a higher prevalence of short sleep (PR = 1.14 [1.05–1.23]). Among women who did shift work, financial strain was associated with a 22% (PR = 1.22 [1.03–1.45]) higher prevalence of short sleep. Conclusion These findings may inform interventions aimed at addressing stressors associated with poor sleep.