Investigators Link Sexual Orientation to Increased Sleep Issues Among Adolescents

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According to the study, gay and bisexual adolescents show higher rates of sleep issues and sleep disturbances.

Following an evaluation of the relationship between gay or bisexual adolescents and sleep behavior, results suggest that sexual minority status may be a risk factor for sleep problems in early adolescence.1

In the study population of more than 8500 adolescents, 4.4% identified as gay or bisexual. This subgroup was associated with difficulty falling asleep, staying asleep, and disturbance during sleep.

Jason Nagata, MD, Assistant Professor of Pediatrics at the University of California, San Francisco, School of Medicine, and the team of investigators, used data from the Adolescent Brain Cognitive Development (ABCD) Study, a longitudinal study of brain development and health among children in the US. The analysis included data from the second year of the ABCD study, consisting of 8563 early adolescents aged 10-14 years.

Assessing Adolescent Sleep Problems

The sexual minority status of participants was identified through a self-reported questionnaire to assess the association between adolescents identifying as gay or bisexual and two measures of sleep problems: self-reported trouble falling or staying asleep, and caregiver-reported sleep disturbance.

Investigators also tested depressive problems, stress problems, family conflict, and parental monitoring as potential mediators, to understand the mechanism behind the association between sexual orientation and sleep problems.

The identified association was based on self-reports of trouble falling or staying asleep and caregiver reports of sleep disturbance. Specifically, sexual minority youth had a higher risk of trouble falling or staying asleep (risk ratio [RR] = 2.24, 95% confidence interval [CI] = 1.88-2.68) and caregiver-reported sleep disturbance (RR = 1.50, 95% CI = 1.29-1.75).

Data also demonstrated this association between sexual minority status and trouble falling or staying asleep was partially mediated by more significant depressive problems, as well as more family conflict, and less parental monitoring.

The team of investigators stated the findings of the study indicated sexual minority status as a potential risk factor for sleep problems in early adolescence. Additional potential mediators, such as depressive problems, stress, family conflict, and less parental monitoring may partially explain the relationship.

The results highlighted the importance of addressing the mental health and family dynamics of gay and bisexual adolescents to improve their sleep health and overall well-being. The implications of the data are critical for healthcare providers, parents, and policymakers, according to the study.

Healthcare providers should screen this youth population for sleep problems and mental health issues and provide appropriate interventions.

Investigators acknowledged the limitations of the research to be considered when interpreting the findings. The study used cross-sectional data, which limits the ability to establish causality between sexual minority status and sleep problems. Another limitation noted was the reliance on self-reported data, which may be subject to reporting biases.

Additionally, the study did not account for potential confounders such as socioeconomic status and physical health, and therefore, the team called for future studies of longitudinal data and account for potential confounders to strengthen the findings.

“Our results indicate that sexual minority status may be linked to sleep disturbance in early adolescence,” investigators wrote. “Depressive problems, stress, family conflict, and less parental monitoring partially mediate disparities in sleep health for sexual minority youth. Future research could test interventions to promote family and caregiver acceptance and mental health support for sexual minority youth to improve their sleep and other health outcomes.”


  1. Nagata JM, Lee CM, Yang JH, et al. Sexual Orientation Disparities in Early Adolescent Sleep: Findings from the Adolescent Brain Cognitive Development Study [published online ahead of print, 2023 Mar 21]. LGBT Health. 2023;10.1089/lgbt.2022.0268. doi:10.1089/lgbt.2022.0268