0136 Associations between Experiences of Racial Discrimination and Sleep Health During Pregnancy

Abstract Introduction Racial discrimination is associated with poorer sleep health in non-pregnant adults. However, the relationship between experiences of discrimination and antenatal sleep health remains poorly understood. We aimed to evaluate associations between experiences of discrimination and sleep health during pregnancy, as measured both by self-report and actigraphy. Methods We conducted a secondary analysis of the nuMoM2b pregnancy cohort. Participants completed the Experiences of Discrimination Scale, the Women’s Health Initiative Insomnia Rating Scale (WHIIRS), and the Epworth Sleepiness Scale (ESS). A subset (n=658) also completed 7 days of wrist actigraphy. We evaluated sleep health using six continuous measures based on the AHA Multidimensional Sleep Health framework: sleep regularity, alertness, timing, efficiency, duration, and insomnia. We also created a sleep health composite score by dichotomizing sleep domains using established cutoffs (0=did not meet cutoff; 1=met cutoff): sleep regularity (midpoint SD ≤60 minutes), alertness (ESS score ≤10), timing (midpoint 2-4AM), efficiency (sleep efficiency ≥85%), duration (≥ 7 hours), and lack of insomnia symptoms (WHIIRS ≤9). These domains were then summed to create a composite score ranging from 0 to 6 (higher=more favorable sleep health). We used linear regression to examine associations between experiences of discrimination and each continuous sleep health variable and the composite sleep score. Results The sample included 8,718 pregnant people (61% non-Hispanic White, 16.4% Hispanic, 13% non-Hispanic Black, 4% Asian; 30% living < 200% of the federal poverty level). Most (76%) reported no experiences of discrimination, 17% reported 1-to-2 experiences, and 7% reported ≥3 experiences. Discrimination was reported more commonly by Asian (49%), Black (42%), and Hispanic (34%) people compared to non-Hispanic white (13%) people (p<.0001). Experiences of discrimination were associated with higher WHIIRS insomnia scores (□=.05, p<.0001), more daytime sleepiness (□=.06, p<.0001), more sleep fragmentation (□=.16, p<.0001), and worse sleep efficiency (□=-.13, p=.0008), but not sleep duration or midpoint. Experiences of discrimination were also associated with lower (i.e. less favorable) composite sleep scores (□=-.18, p<.0001). Conclusion Experiences of discrimination may be an important social determinant of sleep health among pregnant people. Research could evaluate whether interventions to mitigate the harmful effects of discrimination may promote better sleep health among pregnant women. Support (if any) NHLBI/NICHD