LAUSR

STUDY OBJECTIVE To assess whether perceived racial discrimination is associated with insomnia among Black women. METHODS Data on everyday and lifetime racism and insomnia symptoms were collected from questionnaires administered in the Black Women's Health Study, an ongoing prospective cohort of Black women recruited in 1995 from across the U.S. In 2009, participants completed five questions on the frequency of discriminatory practices in daily life (everyday racism) and six questions on ever experiencing unfair treatment in key institutional contexts (lifetime racism). In 2015, the Insomnia Severity Index was used to assess insomnia symptoms. We estimated odds ratios (ORs) and 95% confidence intervals (CIs) for associations of racism with insomnia, using multivariable logistic regression models adjusted for potential confounders. RESULTS The 26,139 participants in the analytic sample were 40-90 years old (median = 57 years, standard deviation = 9.6 years). Higher levels of everyday racism and lifetime racism were positively associated with subthreshold (ptrend<0.01) and clinical insomnia (ptrend<0.01). Results remained unchanged after further adjustment for sleep duration and shift work. CONCLUSIONS Higher levels of perceived racism were associated with increased odds of insomnia among middle-aged and elderly Black women. Thus, perceived racism may contribute to multiple racial health disparities resulting from insomnia. Helping minority populations cope with their experiences of discrimination may decrease the significant public health burden of sleep disruption and subsequent diagnoses.