Inequities in sleep duration among gender and sexual minority adolescents.

Objectives: Gender and sexual minority adolescents face health inequities compared to cisgender, heterosexual peers, including lower sleep duration. Our ability to measure these inequities recently expanded, as the 2023 Youth Risk Behavior Survey's updated gender/sexuality items provide an opportunity to examine these inequities in a large, nationally-representative sample of adolescents.

Methods: Analyses (n=20,103 students, 2023 national YRBS, grades: 9-12) estimated survey-weighted prevalence of 3 sleep duration outcomes across gender and sexuality groups: sufficient sleep (8+ hours/night), short sleep (≤6), and extremely limited sleep (≤4). Survey-weighted logistic regressions compared outcomes between gender/sexual minority groups and cisgender/heterosexual peers, adjusting for demographic confounding.

Results: Sleep duration was consistently lower for gay/lesbian, bisexual, "another unlisted sexual identity" and transgender adolescents, plus those unsure of their gender or sexual identity (e.g., adjusted Odds Ratio for extremely limited sleep ["another unlisted sexual identity" vs. heterosexual]:3.14; 95% confidence interval: 2.00-4.92). For many gender and sexual minority groups, extremely limited sleep was more common than sufficient sleep.

Conclusions: Sleep duration is limited among adolescents, and this, in conjunction with inequities on the basis of gender/sexuality, warrants intervention.