0257 Maladaptive Coping Mediates Associations Between Everyday Racial/Ethnic Discrimination and Insomnia Symptoms

Abstract Introduction Structural and interpersonal racism contribute to sleep disparities, likely due in part to heightened arousal/vigilance associated with the chronic stress caused by racial/ethnic discrimination. While working to address structural inequities is essential, it is important to identify how individuals cope – whether healthy/adaptive or maladaptive – with exposure to racial/ethnic discrimination to inform intervention targets since myriad coping strategies may either drive or buffer the effects of racial/ethnic discrimination on insomnia symptoms. Our study is the first to investigate whether associations between everyday racial/ethnic discrimination (e.g., treated as less intelligent/worthy/honest than others) and insomnia symptoms are mediated by coping strategies. Methods We used data collected over two follow-up periods from 29,137 women (n=903 Latina, n=1,702 non-Hispanic (NH)-Black, and n=26,532 NH-White) enrolled from 2003-2009 (mean±SD age=54.9±8.5 years) in the Sister Study cohort. In 2008-2012, participants self-reported everyday racial/ethnic discrimination experiences (ever vs. never) and healthy/adaptive (e.g., using emotional support) and maladaptive (e.g., behavioral disengagement) coping strategies (‘not at all=1’ to ‘a lot=4’). Self-reported insomnia symptoms (yes vs. no to either difficulty falling or staying asleep) were obtained between 2017-2019. Mediation analysis was performed using PROCESS macro adjusting for sociodemographic/health (e.g., age, sleep medication use) characteristics to provide bias-corrected bootstrapped standard errors and confidence intervals for total, direct, and indirect effects. Results Overall, 9% of women reported everyday racial/ethnic discrimination, and prevalence varied by racial/ethnic group (79% among NH-Black, 31% Latina, and 4% NH-White). All racial/ethnic groups reported similar healthy/adaptive (mean±SD overall score=16.2±2.4) and maladaptive (mean±SD overall score=7.1±1.6) coping styles. The prevalence of insomnia symptoms was also similar across racial/ethnic groups (39%-44%). Maladaptive coping fully mediated/explained the relationship between everyday racial/ethnic discrimination and insomnia symptoms for NH-Black (βdirect effect=0.02, 95% CI -0.229, 0.271; βindirect effect=0.03, 95% CI 0.006, 0.062) and partially mediated/explained for NH-White (βdirect effect=0.24, 95% CI 0.107, 0.367; βindirect effect=0.04, 95% CI 0.025, 0.048) women, but healthy/adaptive coping did not mediate/explain this relationship across racial/ethnic groups. Conclusion Maladaptive coping strategies explain relationships between racial/ethnic discrimination and insomnia symptoms among NH-Black and NH-White women, underscoring the need for interventions that address maladaptive coping strategies to mitigate the impact of racial/ethnic discrimination on sleep disturbances. Support (if any)