1138 The Association Between Racial Discrimination During COVID-19 and Sleep Quality Among Asian Americans

Introduction The positive association between racial/ethnic discrimination and poor sleep health has been well documented among racial/ethnic minoritized populations in the US. Although Asian Americans experienced a rise in anti-Asian discrimination during the COVID-19 pandemic, they remain underrepresented in sleep studies. Studies suggest that the positive association between discrimination and poor health outcomes is stronger with increased levels of acculturation among Asian Americans, however, this modifying effect has not been tested in sleep studies. Our aims were to examine the association between racial discrimination experienced during COVID-19 (COVID discrimination) and poor sleep quality(SQ) and test differences in this association by English proficiency, a proxy for acculturation, among a sample of Asian Americans. Methods Using survey data from a sample of Korean American adults living in the Southeastern US (n=360), we conducted logistic regression analyses to test the association between COVID discrimination and poor SQ. We progressively adjusted for age, gender, education, nativity status, and English proficiency. We conducted moderation analyses (COVID discrimination*English proficiency) in fully adjusted models. COVID discrimination was assessed using a count of discriminatory experiences reported during the COVID-19 pandemic. Self-reported English proficiency was dichotomized into high and low proficiency. Poor SQ was determined using Pittsburgh Sleep Quality Index scores >5. Results Most participants were immigrants (98.61%) and highly educated (79.17%). About half of the sample identified as women (49.33%) and had high English proficiency (55.28%). Mage=40.67 years (SD=12.18). On average, participants reported < 1 experience of COVID discrimination and the majority reported good SQ (68.33%). Every additional COVID discrimination experience was associated with 33% increased odds of poor SQ (OR=1.33, 95%CI: 1.10-1.61, p< 0.001) in fully adjusted models. English language fluency did not moderate this association. Conclusion Although the height of COVID-19 pandemic has subsided, these findings shed significant light on the persistent impact of racial discrimination, specifically its adverse effects on the sleep quality of Asian Americans. There is urgent need to advocate for a proactive approach in tackling anti-Asian discrimination. If replicated through larger-scale studies, the findings may suggest that addressing anti-Asian discrimination is essential to supporting good sleep quality among members of the Asian American community. Support (if any)