The Longitudinal Impact of Racial Discrimination on Sleep Quality Among Filipino and Korean Americans

Background: Sleep quality among Asian American youth is influenced by various factors, including racial discrimination. Previous studies have predominantly utilized cross-sectional designs to explore this relationship, which limits the ability to determine causal/temporal pathways and understand how experiences of discrimination influence sleep patterns over time. To address this gap, this longitudinal study uses data from the Midwest Longitudinal Study of Asian American Families (MLSAAF) to investigate how racial discrimination impacts Filipino American and Korean American youth over time. Drawing on the Stress Process Theory (Pearlin, 1999), which emphasizes how social stressors and coping resources shape health outcomes, this study conceptualizes racial discrimination as a stressor that contributes to sleep quality. This study seeks to provide a more dynamic understanding of how experiences of racial discrimination affect sleep over time. The study also explores how demographic factors such as nativity play a role, aiming to dissect the complex interplay between personal circumstances and external impacts on sleep quality.

Methods: This longitudinal study utilized data from the MLSAAF that has been following Filipino American and Korean American families. This study used data from the second (Nwave2 = 610) through the fourth wave (Nwave4 = 612). Sleep quality was assessed using a 9-item self-report measure. Experiences of racial discrimination were measured with a 5-item scale. Demographic factors such as age, sex, nativity, and socioeconomic status (SES) were also included as covariates. The analysis first addressed the equality of between- and within-subjects effects of racial discrimination, and then stepwise mixed-effects regression models for each ethnic group were employed to explore (1) the impact of racial discrimination on sleep quality, accounting for demographics, and (2) how these relationships differed by nativity.

Results: Across both ethnic groups, the rates of racial discrimination and poor sleep quality increased over time. Females reported a higher level of sleep disturbances compared to males, and participants with higher SES reported fewer sleep disturbances. Regarding nativity, U.S.-born Filipino Americans reported fewer sleep disturbances than foreign-born FA but U.S.-born Korean Americans reported more than foreign-born KA. Furthermore, both between- and within-subjects effects of racial discrimination were associated with more sleep disturbances. For Korean Americans, the between-subject effect of discrimination was significantly linked to increased sleep disturbances only among the U.S.-born group, while nativity did not show a significant moderation within the Filipino American group.

Conclusion and Implication: The findings extend previous research by demonstrating that the association between racial discrimination and sleep quality observed in cross-sectional studies persists in longitudinal analyses. Notably, both between- and within-subject effects of racial discrimination on sleep quality were observed, strengthening the robustness of these findings. Additionally, this study highlights the importance of studying subgroup differences by nativity in studying sleep quality. That is, for Korean Americans, U.S.-born group on average reported more sleep disturbances and the impact of discrimination was only significant among U.S.-born group. Further research is necessary to understand these differences. For social workers serving Asian American communities, it is crucial to consider racial discrimination experiences when addressing clients' concerns about sleep quality.