1064 Stress and Violence Exposure Predict Poor Sleep Quality in Sexual and Gender Minorities

Abstract Introduction Nearly one-third of U.S. adults experience poor sleep quality. Sleep health is critical for health and well-being, however sleep among sexual and gender minorities (SGM), is understudied. Given the disproportionate prevalence of psychosocial stressors and violence resulting from discrimination in this population, and documented linkages between stress and sleep, we ask: What are the associations between perceived stress, exposure to violence, and sleep quality among SGM living in the U.S.? Methods We analyzed cross-sectional data for self-identified SGM individuals (N=204), aged 21 to 82, who completed an online Qualtrics survey about LGBTQ+ experiences and health. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), perceived stress via the Perceived Stress Scale, and violence exposure with a version of the PRIDE Lifetime Health and Experiences Survey. Sociodemographic data included gender identity, age, education, race and/or ethnicity. Unadjusted and adjusted multivariable linear regression models identified independent associations of perceived stress and violence exposure with sleep quality, adjusting for relevant sociodemographic covariates. Results All participants identified as sexual minorities (Mage 32.9, SD = 9.2); most were female (71.1%). Two-thirds (75.5%) reported a college or graduate/professional degree or greater. 63.7% identified as White; 12.3% Middle Eastern/North African, 2.5% American Indian/Alaskan Native, 9.3% two or more races, 4.9% Black/African American, and 7.4% Hispanic or Latino. Nearly all participants (males = 89.1%; females = 92%) scored >6 on the PSQI, indicating poor sleep quality. Participants reported an average of 3.3 (SD = 3.8) violence exposures in the preceding year. In fully adjusted models, greater perceived stress (β = 2.36, p < 0.001) and greater violence exposure (β = 0.14, p = 0.022) were associated with worse sleep quality (β = 6.56, p < 0.001). Sensitivity analyses confirmed the robustness of these findings. Conclusion In our sample, SGM experience exceptionally high rates of poor sleep quality (>89%), independently associated with perceived stress and violence exposure. These findings underscore the need for comprehensive interventions addressing minority stress and violence prevention at individual, healthcare, and policy levels. Improving SGM sleep health requires trauma-informed approaches that address the unique psychosocial stressors faced by this vulnerable community. Support (if any) NA