Introduction:
There is growing evidence that sexual minority (e.g., gay/lesbian and bisexual) adults have higher cardiovascular disease (CVD) risk and report shorter sleep duration than heterosexual adults. Previous research suggests that sleep duration is inversely associated with CVD risk in adults. To date, no study has examined the associations of sleep duration and objectively measured CVD risk in sexual minority adults.
Hypothesis:
We investigated the hypothesis that sexual minority adults have higher systolic and diastolic blood pressure (BP) and waist-to-height ratio (WHtr) than heterosexual adults and that sleep duration mediates these associations.
Methods:
Cross-sectional data from the National Health and Nutrition Examination Survey (2005-2016) were used. Sexual identity and sleep duration were assessed based on self-report. We used the average of systolic and diastolic BP across two readings to assess BP. We calculated the ratio between waist and height (in cm). We used sex-stratified linear regression models to compare CVD risk factors between sexual minority (i.e., gay/lesbian and bisexual) and heterosexual adults. Next, we used path analysis to determine whether the associations of sexual identity with systolic and diastolic BP and WHtr were mediated by sleep duration. Models were adjusted for demographic characteristics and tobacco use.
Results:
The sample included 17,858 adults. Participants had a mean age of 38.0 (SD = 12.1), 48.4% were female, and 65.6% were Non-Hispanic White. Gay men reported higher sleep duration (
B
0.27 [0.07]) relative to heterosexual men. However, WHtr and diastolic BP did not differ between gay and heterosexual men. No differences in sleep duration or diastolic BP were found between sexual minority and heterosexual women. Bisexual women had a higher systolic BP (
B
1.64 [0.70]) and WHtr (
B
0.02 [0.01]) than heterosexual women, but these associations were not mediated by sleep duration. Compared to heterosexual men, sleep duration partially mediated the associations of sexual identity with diastolic BP (
B -
0.12 [0.05]) and WHtr (
B -
0.01 [0.01]) in gay men.
Conclusion:
This is the first study to assess the associations of sexual identity, sleep duration, and an objectively measured marker of CVD risk in a nationally representative sample of US adults. We found that bisexual women had higher systolic BP and WHtr than heterosexual women and that higher sleep duration was associated with lower diastolic BP and WHtr in gay men. Findings can inform future studies investigating the interplay between sexual identity, sleep duration, and CVD risk in adults.
