Discrimination based specifically on weight or a physical disability was associated with worse sleep quality as was everyday discrimination in a study of 9,223 older participants (mean age 66.7 years) with 12.8 years of education. The study aimed to identify mediating pathways between discrimination and sleep quality and assess the effects of depressive symptoms, anxiety symptoms, sleep quality, and non-restfulness. Researchers found:

• More experiences with everyday discrimination were associated with worse sleep quality.

• The direct effect was lower in both magnitude and significance when psychological distress was added.

• Psychological distress also fully mediated the relation between everyday discrimination and non-restfulness.

• Individuals who experienced physical disability-based discrimination had worse sleep quality than those who did not.

• Among individuals with obesity, psychological distress fully mediated the relation between discrimination and sleep quality and partially mediated the relationship between weight discrimination and non-restfulness.

Citation: Vaghela P, Sutin AR. Discrimination and sleep quality among older US adults: the mediating role of psychological distress. [Published online ahead of print April 4, 2016]. Sleep Health. doi:http://dx.doi.org/10.1016/j.sleh.2016.02.003.

Commentary: Discrimination against race, gender, age, sexual orientation, religion and many other traits is far too common and has severe health effects. It has negative psychological effects, leading to higher levels of depression and anxiety among those who experience discrimination. There are also negative physical health consequences including higher levels of hypertension, obesity and substance abuse. It appears that impaired sleep is also a consequence of discrimination and that impaired sleep likely leads to decreased resiliency, decreased concentration, and decreased energy, all of which have consequences of their own. —Neil Skolnik, MD