1085 The Role of Sexual Orientation and Race on Depression Among Participants with Insomnia

Abstract Introduction Insomnia is a well-established risk factor for depression. Prior research has shown that social discrimination drives disparities in insomnia, leading to worse sleep in marginalized populations such as Black Americans and sexual minorities (Lesbian, Gay, Bisexual, and Queer+ [LGBQ+]). By extension, it may be that Black and LGBQ+ Americans who develop insomnia may also experience greater risk for insomnia; however, this has not been examined. This study compared rates of comorbid depression by race and sexual orientation in patients with insomnia. Methods Participants with insomnia completed a survey assessing depression, experiences with discrimination, race, and sexual orientation. Sexual orientation and race were used to further classify groups into Black LGBQ+ (n=27), White LGBQ+ (n=91), Black heterosexual (n=128), and White heterosexual (n=291). Data analysis included chi-square analysis, two-way ANOVA, and post-hoc t-tests to examine group differences in depression and discrimination between Black LGBQ+, Black heterosexuals, White LGBQ+, and White heterosexuals with insomnia. Results Depression was significantly higher among LGBQ+ participants than heterosexual participants, regardless of race. Specifically, 70.4% of Black LGBQ+ participants demonstrated clinical depression compared to 44.5% of Black heterosexuals. Similarly, 76.9% of White LGBQ+ participants reported clinical depression compared to 55.7% of White heterosexuals. Subsequent t-tests revealed Black LGBQ+ participants (M=12.1, SD=2.6) had significantly less depression symptoms compared to White LGBQ+ (M=13.6, SD=3.5) participants despite similar, non-significantly different levels of discrimination experienced by White LGBQ+ participants (M=7.6, SD=3.7) as Black LGBQ+ participants (M=8.9, SD=4.3). Conclusion These findings suggest LGBQ+ people may experience a unique vulnerability to comorbid depression and insomnia. Furthermore, consistent with the Black-White Paradox of mental health, Black racial identity may play a protective role against comorbid depression in insomnia. Future studies should investigate possible mechanisms underlying co-morbid depression and insomnia in LGBQ+ communities and consider other intersecting marginalized identities that may have cascading effects on sleep and wellbeing. Support (if any)