Disparities in sleep duration among discordant heterosexual adolescents

Sexual minority adolescents have worse sleep health than their peers. Adolescents who identify as heterosexual and report prior same-sex sexual contact (termed 'discordant heterosexuals') have elevated health risks, but little is known about this group's sleep health. This study examined 2015-2017 Youth Risk Behavior Survey data (n = 12,773 high school students) comparing discordant heterosexuals to their concordant (i.e. sexual identity is concordant with reported sex of sexual contact) heterosexual, bisexual, gay and lesbian peers on three sleep outcomes: sufficient (>= 8 hours), short (<= 6 hours) and extremely limited sleep (<= 4 hours). Both discordant heterosexual (aOR:0.64, 95% CI:0.47, 0.86) and bisexual students (aOR:0.69, CI:0.56, 0.85) had lower odds of sufficient sleep compared to concordant heterosexuals, even after adjustment for demographic factors and substance use. Discordant heterosexual (aOR:1.29, CI:1.01, 1.66) and bisexual (aOR:1.74, CI:1.54, 1.98) students have higher odds of short sleep. Discordant heterosexual (aOR:1.94, CI:1.36, 2.77) and bisexual students (aOR:2.72, CI:2.23, 3.31) also had higher odds of extremely limited sleep. Victimization may partially explain some of these associations. Sleep health is one factor that may drive health disparities, and efforts to ensure that adolescents are safe and secure in sexual behavior and identity is important to reducing these disparities.