Sexual orientation and sleep problem among Chinese college students: Mediating roles of interpersonal problems and depressive symptoms.

Abstract Background This study aimed to investigate disparities in sleep quality between sexual minority and heterosexual college students, and to examine the serial multiple mediation effects of interpersonal relationships and depressive symptoms on sexual minority disparities in sleep quality. We also explored the sex differences in the mediating effects. Methods Data were drawn from the 2019 School-based Chinese College Students Health Survey using a multi-stage, stratified-cluster, random-sampling method to examine the risk factors of sleep disparities and the mediation effects. Measures included sexual orientation, perceived interpersonal relationships (i.e., family, teachers, and peer relationship), depressive symptoms, sleep quality, and other covariates. Results Of all the college students in the analysis, 95.8% were heterosexual, 4.2% were sexual minorities. In the adjusted model without mediation, sexual minority students were at a higher risk of poor sleep quality (P  Limitations Causal inference is limited due to the cross-sectional design. Conclusions Interventions to prevent or manage sleep disorders of sexual minority college students may yield better results if they consider the effects of improving interpersonal relationships and depression symptoms comprehensively than targeting sleep problems alone.