Adapting the Health Stigma and Discrimination Framework to understand the association between stigma and sleep deficiency: A systematic review

Nwanaji-Enwerem, Uzoji; Condon, Eileen M.; Conley, Samantha; Wang, Katie; Iheanacho, Theddeus; Redeker, Nancy S.

doi:10.1016/j.sleh.2022.03.004

Cited by 15 publications

(9 citation statements)

References 74 publications

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“…Stigma has been identified as a major barrier to good treatment adherence and a driver of TB transmission ( 15 , 34 ). It can have a negative impact on relationships, psychological well-being, and sleep quality as a mediator and moderator ( 10 ). Excessive or prolonged perceived stress can activate the hypothalamic-pituitary-adrenal (HPA) axis, releasing hormones such as cortisol, which can suppress the immune system and lead to sleep deficiency ( 35 , 36 ), with an underlying biopsychosocial mechanism that includes neurobiological underpinnings such as neuroendocrine changes, as well as psychosocial factors such as a lack of social support.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have demonstrated sleep quality to be strongly associated with several factors. A recent study reported that stigma, which is marked by labeling, stereotyping, and prejudice, has a strong relationship with self-reported characteristics of sleep deficiency, including insomnia and sleep duration ( 10 ), and this correlation was significantly mediated by stress and depression ( 11 ). Accumulating evidence also suggests that perceived stress is a significant risk factor for reduced sleep quality ( 8 , 12 ).…”

Section: Introductionmentioning

confidence: 99%

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Sleep quality and its associated factors among patients with tuberculosis: A cross-sectional study

Liu

Lan

Bai

et al. 2023

Front. Public Health

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BackgroundTuberculosis (TB) patients commonly suffer from sleep issues owing to various adverse drug reactions (ADRs), disease symptoms, and the contagious nature of their disease. These sleep issues negatively affect the treatment outcome and quality of life. However, the prevalence of sleep disturbance and its associated factors among TB patients have rarely been reported.MethodsA total of 497 inpatients with TB from three hospitals in China were enrolled in this cross-sectional study to investigate their sleep quality using the Pittsburgh sleep quality index (PSQI). Clinical data, including demographic information, TB-related stigma, perceived stress, and nutrition- and immunity-related indicators, were also collected to explore the factors associated with sleep disturbance among the recruited patients.ResultsApproximately 70% of the recruited patients reported a sleep disturbance to varying degrees, presenting poorer global and subjective sleep qualities, longer sleep latency, shorter sleep duration, lower sleep efficiency, more frequent sleep disturbances, greater use of sleeping medication, and more severe daytime dysfunction. Furthermore, the body mass index (BMI), hemoglobin levels, albumin levels, and T lymphocyte count of the patients in the poor sleep quality group were significantly lower than those in the good sleep quality group (p < 0.05). Increasing age, higher income, drug resistance, higher stigma or stress perception, lower albumin levels, and lower CD4 levels were significantly associated with sleep disturbance among TB patients (p < 0.05).ConclusionThree-quarters of the participants were found to suffer from a probable sleep disturbance. And sleep problems are linked to biological traits that interact with psychological, cultural, and social factors in complex ways. It is therefore important to pay attention to the sleep quality of TB patients, especially those with the identified risk factors. Besides, taking care of these risk factors may prove to be an effective sleep management strategy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sleep quality and its associated factors among patients with tuberculosis: A cross-sectional study

Liu

Lan

Bai

et al. 2023

Front. Public Health

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“…Although it was unclear whether PR directly predicts sleep quality, many studies reported that chronic patients with low-level PR were more vulnerable to the adverse effects of poor sleep quality during the in uenza pandemic, which reveals the critical link between PR and sleep quality [40] . In addition, stigma was considered a common obstacle to seeking treatment in the research on the determinants of help-seeking behavior of insomnia patients [41] . Speci cally, studies had shown that people with sleep quality problems might have a more strict sense of shame [42] .…”

Section: The Moderating Role Of Sleepmentioning

confidence: 99%

The Impact of Psychological Resilience on Chronic Patients’ Depression During the dynamic Zero-COVID policy: The Mediating Effect of Stigma and the Moderating Role of Sleep

Mei

Yang

Liu

et al. 2022

Preprint

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Objective Chronic patients are experiencing depression caused by themselves or the surrounding environment, how to cope with the change of mentality and adjust the psychological stress response, especially under the background of the current dynamic Zero-COVID policy in China, is a problem worth further discussion. The researchers constructed a mediating regulation model to test the influence of psychological resilience on depression of chronic patients during dynamic Zero-COVID, as well as the mediating role of stigma and the regulating role of and the moderating role sleep. Method From October 2021 to February 2022, a multi-stage stratified sampling method was used to collect data in Shangcheng District of Hangzhou City, Zhejiang Province. We used the random number table method. Firstly, a third-class hospital was randomly selected from Shangcheng District. Secondly, departments were randomly selected from the hospital. Thirdly, survey points were set up in each department, and chronic patients were randomly selected from each survey point. In addition, chronic medical illness burden was assessed using the Cumulative Illness Rating Scale-Geriatrics (CIRS-G), psychological resilience was measured by the Conner-Davidson Resilience Scale (CD-RISC), stigma was measured by the Stigma Scale for Chronic Illness (SSCI), sleep was measured by the Pittsburgh Sleep Quality Index(PSQI) and depressive symptoms were estimated by the Patient Health Questionaire-9(PHQ-9). SPSS (version 21) and PROCESS (version 4.0) were used for correlation analysis, mediation analysis, and mediated moderation analysis. Results Psychological resilience was negatively correlated with depression, stigma and sleep. Depression was positively correlated with stigma and sleep. Stigma and sleep were positively correlated; Stigma played a mediating role in the relationship between psychological resilience and depression; Sleep moderated the first half of the pathway " psychological resilience → stigma → depression" . Conclusion Psychological resilience affected depression directly and also indirectly through stigma. At the same time, sleep played a moderating role between psychological resilience and depression. The correlation between psychological resilience and stigma was stronger when levels of sleep levels were higher.

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“…A growing body of research provides empirical evidence for an association between discrimination and sleep problems (14,23). Although much of this work has been cross-sectional and based on self-report measures of sleep, several studiesthe earliest of which was facilitated by the honoree of this special issue-indicate that the association holds up longitudinally and with objective measures (24)(25)(26)(27)(28)(29)(30)(31).…”

Section: Introductionmentioning

confidence: 99%

Do Sleep Problems Exacerbate the Mental Health Consequences of Discrimination among Adults?

Fuller-Rowell,

Zeringue,

Saini

et al. 2024

Psychosom Med

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Objective An emerging literature suggests that sleep may play an important role in moderating the association between discrimination and mental health problems among adolescents. However, few if any studies have considered this topic among adults. Addressing this knowledge gap, the current study examined multiple sleep parameters as moderating variables in the association between discrimination and mental health problems among adults. Methods Participants were 874 adults residing in small towns and semi-rural contexts within the Southeastern region of the United States (M age = 41 years, SD = 7; 57% female; 31% Black, 69% White; 52% income-to-needs <2). Sleep duration and night-to-night variability in duration were assessed using wrist actigraphy. Established self-report measures were used to assess global sleep problems, experiences of discrimination, and mental health problems (anxiety, depression, and externalizing symptoms). Results Experiences of discrimination were associated with more depression, anxiety, and externalizing problems. Two out of three sleep parameters were found to moderate the effects of discrimination on mental health. The association between discrimination and externalizing problems (but not anxiety or depression) was attenuated among those with less night-to-night variability in sleep duration. The associations between discrimination and anxiety and externalizing problems (but not depression) were attenuated among those with fewer global sleep problems. Less variability in sleep duration and fewer global sleep problems were also directly associated with lower levels of depression, anxiety, and externalizing problems. Conclusions Greater consistency in sleep duration from night-to-night, and fewer overall sleep problems appear to mitigate risk of mental health problems among adults, particularly in contexts where discrimination is prevalent.

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Adapting the Health Stigma and Discrimination Framework to understand the association between stigma and sleep deficiency: A systematic review

Cited by 15 publications

References 74 publications

Sleep quality and its associated factors among patients with tuberculosis: A cross-sectional study

Sleep quality and its associated factors among patients with tuberculosis: A cross-sectional study

The Impact of Psychological Resilience on Chronic Patients’ Depression During the dynamic Zero-COVID policy: The Mediating Effect of Stigma and the Moderating Role of Sleep

Do Sleep Problems Exacerbate the Mental Health Consequences of Discrimination among Adults?

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