The role of sleep quality and duration in associations between daily minority stress and next-day suicidal ideation in LGBTQ+ youth

BACKGROUND: LGBTQ+ youth experience greater minority stress, poorer sleep, and heightened suicidal ideation (SI) compared to non-LGBTQ+ youth. Despite the high within-person variability of these biopsychosocial factors, few studies have utilized intensive longitudinal methods to examine their daily associations. METHOD: This study addresses this gap by enrolling LGBTQ+ youth aged 13-24 with past-year SI and current depressive symptoms into a smartphone-based ecological momentary assessment (EMA) study, administering three surveys per day for 28 consecutive days. Data were aggregated at the day level. Fifty participants (average age = 18.52 years, 78.0 % non-Hispanic White) contributed a total of 999 surveys. Using linear multilevel models with varying intercepts, we tested whether sleep quality or sleep duration mediated and/or moderated the within-person associations between daily minority stress (e.g., discrimination, rejection) and next-day active SI (desire to kill oneself), passive SI (desire to not stay alive), and non-suicidal self-injury ideation intensity. RESULTS: Mediation analyses were non-significant; however, moderation analyses indicated that better sleep quality, but not sleep duration, rendered the association between minority stress and next-day passive SI negative. CONCLUSIONS: Findings suggest that better sleep quality might mitigate the suicidogenic impact of minority stress from one day to the next. Public health and clinical interventions aimed at reducing minority stress exposure and enhancing sleep quality may hold promise in lowering suicide risk among LGBTQ+ youth.