RACIAL/ETHNIC DISPARITIES IN ADOLESCENT SLEEP DURATION AND MENTAL HEALTH: THE MODERATING ROLE OF PARENTCHILD CONNECTEDNESS

• Published in: Journal of adolescent health Vol. 66; no. 2S; p. S89
• Main Authors: So, Marvin, Perry, Nicole B, Langenfeld, Adam D, Barnes, Andrew J
• Format: Journal Article
• Language: English
• Published: New York Elsevier BV 01-02-2020
• Subjects: Adolescents; Age; Averages; Child & adolescent mental health; Circadian rhythm; Connectedness; Ethnic differences; Health problems; Health status; Hmong people; Mass media; Mental health; Mental health care; Middle schools; Pacific Islander people; Poverty; Questionnaires; Racial inequality; Respondents; Rhythm; Rural communities; Secondary schools; Self report; Sleep; Suicidal ideation; Teenagers
• ISSN: 1054-139X; 1879-1972

Purpose: Sleep is an essential process for physical, cognitive, and emotional health, yet adolescents commonly experience inadequate sleep due to both intrinsic (e.g., circadian rhythm shifts) and extrinsic (e.g., media use) factors. Nationally, 58% of middle school-age and 73% of high school-age adolescents do not get the recommended 810 hours of sleep per night (Wheaton et al., 2018). Further, racial/ ethnic minority adolescents consistently demonstrate worse sleep compared to White adolescents (Guglielmo, et al., 2018). The purpose of this study was to examine associations between sleep duration and mental health across and within distinct racial/ethnic groups, and to determine whether parent-child connectedness modifies these relationships. Methods: We analyzed self-report data for 8th, 9th, and 11th grade public school respondents to the 2016 Minnesota Student Survey (N=122,025). We calculated univariate and bivariate statistics, and multivariate logistic regressions to examine whether average school night sleep duration was independently associated with depressive symptoms (via the Patient Health Questionnaire-2), suicide ideation, and suicide attempt, adjusting for child age, sex, region (urban vs. rural), and poverty. Further, we assessed whether parent-child connectedness moderated putative associations. All analyses were conducted for the overall sample and separately for eight mutually exclusive racial/ethnic groups: White, Black, Hispanic, Asian, American Indian, Pacific Islander, Hmong, and Somali. Results: On average, respondents slept 7.0 hours on typical school nights. Approximately 22% of respondents experienced depressive symptoms; 19% had ever considered attempting suicide and 7% had actually attempted suicide. Non-White respondents generally had shorter sleep duration and higher prevalence of negative mental health outcomes. However, Latino and Somali respondents reported more hours of sleep relative to Whites; Hmong and Somali respondents reported lower rates of negative mental health outcomes. In the overall sample, sleep duration was associated with decreased odds of being depressed (AOR: 0.76, p<0.05), considering suicide (AOR: 0.74, p<0.05), and attempting suicide (AOR: 0.71, p<0.05). Parent-child connectedness moderated this relationship - for adolescents who reported greater sleep duration and a greater ability to communicate with a parent, the odds of depression, suicide ideation, and suicide attempts declined relative to adolescents who reported low parent-child connectedness. When examining distinct racial/ ethnic groups, the relationships between sleep and mental health generally remained significant, although effect sizes varied. Further, the added benefit of parent-child connectedness on the relationship between sleep and mental health outcomes was only significant for Whites and Asians. Conclusions: This study shows that in spite of racial/ethnic disparities in sleep and mental health, adequate sleep promotes adolescent mental health, and that strong relationships between parents and adolescents may help to protect against mental health problems in the context of inadequate sleep. Although longitudinal research is needed to better understand the interactions between parent-child connectedness, sleep, and mental health for distinct racial/ethnic groups, adolescent health providers can integrate efforts to assess or improve sleep with strategies aimed at parent-adolescent relationships (e.g., parent education) to optimize young people's mental health.