What question did this study set out to answer?

This study aims to understand sleep health disparities among sexual minority youth and how these differences vary by ethnicity-race and sex.

May 4, 2026

Sleep health in sexual minority youth: An intersectional approach across ethnicity-race and sex-Findings from the Adolescent Brain Cognitive Development (ABCD) Study.

Key Points

This study aims to understand sleep health disparities among sexual minority youth and how these differences vary by ethnicity-race and sex.
Analyzed actigraphy-based sleep data from the Adolescent Brain Cognitive Development Study including 11,052 youth (51% female).
Examined differences in sleep health based on sexual orientation, ethnicity-race, and sex assigned at birth.
Conducted path analyses to assess sleep variations among sexual minority and heterosexual youth.
Sexual minority youth show poorer sleep across multiple dimensions compared to heterosexual youth.
Ethnically and racially minoritized youth experience worse sleep than White youth, and girls show poorer sleep than boys.
Ethnically and racially minoritized girls, in particular, exhibit the most significant sleep disparities, requiring targeted interventions.

Abstract

OBJECTIVES: Sexual minority (lesbian, gay, and bisexual) youth experience heightened risks for poor sleep health than heterosexual youth. However, they are often treated as a homogeneous group, obscuring critical within-group variations. This study examined sleep disparities by sexual orientation and, within sexual minority youth, how these disparities differ by ethnicity-race and sex-two critical social strata consistently linked to sleep disparities. METHODS: = 11.52, 51% female) from the Adolescent Brain Cognitive Development Study. Using actigraphy-based, multidimensional sleep data, youth-reported sexual orientation, and caregiver-reported youth ethnicity-race and sex assigned at birth, we examined sleep differences (1) by sexual orientation within the full sample, and (2) within the sexual minority subsample by ethnicity-race, sex, and ethnicity-race × sex. RESULTS: Path analyses revealed poorer sleep among sexual minority youth across multiple dimensions of average sleep and variability than heterosexual youth. Within the sexual minority subsample, ethnically and racially minoritized youth exhibited poorer sleep than White youth; girls showed poorer sleep than boys; ethnically and racially minoritized girls-representing the group with the most marginalized social strata-consistently exhibited poorer sleep compared with groups with fewer marginalized strata. Supplementary analyses within heterosexual youth showed similar pattern, although sex differences were more mixed. CONCLUSIONS: Sexual minority youth, especially those with more marginalized social strata (e.g., ethnically and racially minoritized youth, girls, and ethnically and racially minoritized girls), experience multidimensional sleep disparities. These disparities emerge as early as ages 10-13. Early, targeted intervention and policy efforts are needed to address and mitigate sleep health inequities in these vulnerable groups.

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