0241 Racial/Ethnic and Socioeconomic Disparities in Circadian Misalignment in Adolescents

Abstract Introduction Prior research has shown sleep health disparities as a function of race/ethnicity and socioeconomic status (SES). However, most studies focused on habitual sleep duration and its night-to-night variability. Few studies have examined the association of these social determinants with circadian misalignment metrics, such as sleep midpoint (SM), sleep irregularity (SI), and social jetlag (SJL). We hypothesize that adolescents who identify as a racial/ethnic minority or from low SES households have greater circadian misalignment as compared to non-Hispanic whites or those from high SES households. Methods We analyzed 377 adolescents from the Penn State Child Cohort (median 16y; 46% female; 22% racial/ethnic minority, of which 58% were Black/African American and 28% Hispanic) who had at least 3 nights of actigraphy. SM was defined as the intra-individual midpoint of the sleep period, SI as the intra-individual standard deviation of the SM across nights, and SJL as the absolute difference between SM on weekdays vs. weekends. SES variables included parent’s professional status, student working status and zip-code level median household income and 5-year average percentage of high school/college graduates. Multivariate general linear models adjusted for sex, age, sleep duration, and sleep variability as well as a composite score of SES variables. Results Adolescents identifying as a racial/ethnic minority, working part-time, belonging to a household of lower professional status, lower median income or with less high-school or college graduates had a significantly delayed SM (p=0.011, p=0.005, p=0.049, p=0.047, p=0.009 and p=0.004, respectively). Adolescents identifying as a racial/ethnic minority and belonging to a household of lower professional status had significantly increased SI (p=0.009 and p=0.028, respectively). Race/ethnicity or SES were not associated with SJL (p≥0.203). The association of race/ethnicity with a delayed SM and increased SI remained significant after adjusting for all covariates, including SES (p=0.009 and p=0.029, respectively). Conclusion Racial/ethnic disparities in the circadian timing of sleep are not fully explained by socioeconomic factors in adolescents. Beyond insufficient sleep, circadian misalignment and its upstream social determinants should also be a target of strategies to prevent sleep health inequalities in historically minoritized racial/ethnic groups. Support (if any) AHA (23PRE1011962), NIH (R01HL136587,R01MH118308,UL1TR000127)