{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:59:18Z","timestamp":1782842358663,"version":"3.54.5"},"reference-count":83,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIR Public Health Surveill"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec sec-type=\"background\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Women and sexual minority individuals have been found to be at higher risk for experiencing poor sleep health compared to their counterparts. However, research on the sleep health of sexual minority women (SMW) is lacking in China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"objective\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to examine sleep quality and social support for Chinese women with varied sexual identities, and then investigate the in-depth relationships between sexual identity and sleep.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"methods\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a cross-sectional web-based survey. All participants completed a structured questionnaire containing a set of sociodemographic items referring to the social-ecological model of sleep health, the Pittsburgh Sleep Quality Index, the Social Support Rating Scale, and social relationships and environment domains of the World Health Organization Quality of Life-abbreviated short version. Pearson correlation coefficients were used to examine the relationship between sleep quality and social support as well as the two domains of quality of life. Structural equation modeling analysis was used to explore the social-ecological relationships.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"results\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 250 cisgender heterosexual women (CHW) and 259 SMW were recruited from July to September 2021. A total of 241 (47.3%) women experienced poor sleep quality and the rate was significantly higher in SMW than in CHW (55.2% vs 39.2%,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.001). Around one-fifth of SMW reported low levels of social support, which was significantly higher than that of CHW (21.6% vs 5.6%,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.001). Pearson correlations showed that overall sleep quality was significantly negatively associated with social support with weak correlations (\n                      <jats:italic>r=<\/jats:italic>\n                      \u22120.26,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;.001). The final structural equation modeling analysis with satisfactory fit indices identified 6 social-ecological pathways, showing that alcohol use, objective support, utilization of support, and perceived social relationship and environment quality of life played important roles in the sleep quality of individuals from their sexual identity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec sec-type=\"conclusions\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>SMW experienced poorer sleep quality compared to CHW. Further research is recommended to address the modifiable factors affecting sleep and then implement tailored sleep improvement programs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2196\/53549","type":"journal-article","created":{"date-parts":[[2025,1,22]],"date-time":"2025-01-22T04:42:42Z","timestamp":1737520962000},"page":"e53549-e53549","source":"Crossref","is-referenced-by-count":2,"title":["Exploring Social-Ecological Pathways From Sexual Identity to Sleep Among Chinese Women: Structural Equation Modeling Analysis"],"prefix":"10.2196","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5145-5484","authenticated-orcid":false,"given":"Chanchan","family":"Wu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0287-8020","authenticated-orcid":false,"given":"Pui Hing","family":"Chau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9062-3540","authenticated-orcid":false,"given":"Edmond Pui Hang","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1010","published-online":{"date-parts":[[2025,1,21]]},"reference":[{"issue":"1","key":"R1","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1016\/j.sleh.2014.12.008","article-title":"Duration, timing and quality of sleep are each vital for health, performance and safety","volume":"1","author":"Czeisler","journal-title":"Sleep Health"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.813943","article-title":"Sleep duration\/quality with health outcomes: an umbrella review of meta-analyses of prospective studies","volume":"8","author":"Gao","journal-title":"Front Med (Lausanne)"},{"issue":"3","key":"R3","doi-asserted-by":"publisher","DOI":"10.1111\/jsr.13775","article-title":"Effect of sleep disturbance on biomarkers related to the development of adverse health outcomes: a systematic review of the human literature","volume":"32","author":"Sivakumaran","journal-title":"J Sleep Res"},{"issue":"1","key":"R4","doi-asserted-by":"publisher","first-page":"9","DOI":"10.5665\/sleep.3298","article-title":"Sleep health: can we define it? Does it matter?","volume":"37","author":"Buysse","journal-title":"Sleep"},{"key":"R5","doi-asserted-by":"crossref","unstructured":"Weaver MD Barger LK . Sleep health as an issue of public safety. In: Grandner MA , editor. Sleep and Health. Academic Press; 2019:489-499. ISBN: 9780128153734","DOI":"10.1016\/B978-0-12-815373-4.00037-X"},{"issue":"2","key":"R6","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1016\/0165-1781(89)90047-4","article-title":"The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research","volume":"28","author":"Buysse","journal-title":"Psychiatry Res"},{"issue":"4","key":"R7","doi-asserted-by":"publisher","DOI":"10.1111\/jsr.13608","article-title":"The multidimensionality of sleep in population-based samples: a narrative review","volume":"31","author":"van de Langenberg","journal-title":"J Sleep Res"},{"issue":"1688","key":"R8","doi-asserted-by":"publisher","first-page":"20150110","DOI":"10.1098\/rstb.2015.0110","article-title":"Sex differences in sleep: impact of biological sex and sex steroids","volume":"371","author":"Mong","journal-title":"Philos Trans R Soc Lond B Biol Sci"},{"key":"R9","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2015.01.020","article-title":"Sleep disparity, race\/ethnicity, and socioeconomic position","volume":"18","author":"Grandner","journal-title":"Sleep Med"},{"key":"R10","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-10-475","article-title":"\u201cSleep disparity\u201d in the population: poor sleep quality is strongly associated with poverty and ethnicity","volume":"10","author":"Patel","journal-title":"BMC Public Health"},{"issue":"2","key":"R11","doi-asserted-by":"crossref","first-page":"176","DOI":"10.5664\/jcsm.27768","volume":"6","author":"Baldwin","journal-title":"J Clin Sleep Med"},{"key":"R12","doi-asserted-by":"crossref","unstructured":"Blanc J Nunes J Williams N Robbins R Seixas AA Jean-Louis G . Sleep health equity. In: Grandner MA , editor. Sleep and Health. Academic Press; 2019:473-480. [doi: 10.1016\/B978-0-12-815373-4.00035-6]","DOI":"10.1016\/B978-0-12-815373-4.00035-6"},{"key":"R13","doi-asserted-by":"crossref","unstructured":"Williams N Jean-Louis G Blanc J Wallace DM . Race, socioeconomic position and sleep. In: Grandner MA , editor. Sleep and Health. Academic Press; 2019:57-76. [doi: 10.1016\/B978-0-12-815373-4.00006-X]","DOI":"10.1016\/B978-0-12-815373-4.00006-X"},{"issue":"1","key":"R14","doi-asserted-by":"publisher","DOI":"10.1111\/jsr.12928","article-title":"Sexual and gender minority sleep: a narrative review and suggestions for future research","volume":"29","author":"Butler","journal-title":"J Sleep Res"},{"key":"R15","doi-asserted-by":"publisher","DOI":"10.1016\/j.ynstr.2022.100488","article-title":"Sleep disturbance and suicide risk among sexual and gender minority people","volume":"21","author":"Dolsen","journal-title":"Neurobiol Stress"},{"issue":"3","key":"R16","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1016\/j.sleh.2019.02.004","article-title":"Sexual orientation and sleep difficulties: a review of research","volume":"5","author":"Patterson","journal-title":"Sleep Health"},{"issue":"2","key":"R17","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1037\/sgd0000473","article-title":"Sleep difficulties of sexual minority adults: evidence from the 2018 National Health Interview Study","volume":"9","author":"Patterson","journal-title":"Psychol Sex Orientat Gend Divers"},{"issue":"6","key":"R18","doi-asserted-by":"publisher","first-page":"621","DOI":"10.1016\/j.sleh.2019.06.006","article-title":"An intersectional approach to examine sleep duration in sexual minority adults in the United States: findings from the Behavioral Risk Factor Surveillance System","volume":"5","author":"Caceres","journal-title":"Sleep Health"},{"issue":"1","key":"R19","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-017-4937-9","article-title":"Health and healthcare disparities among U.S. women and men at the intersection of sexual orientation and race\/ethnicity: a nationally representative cross-sectional study","volume":"17","author":"Trinh","journal-title":"BMC Public Health"},{"issue":"1","key":"R20","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1016\/j.sleh.2017.10.004","article-title":"Sleep duration, sleep quality, and sexual orientation: findings from the 2013-2015 National Health Interview Survey","volume":"4","author":"Galinsky","journal-title":"Sleep Health"},{"issue":"8","key":"R21","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/zsy090","article-title":"Disparities in sleep duration and restedness among same- and different-sex couples: findings from the American Time Use Survey","volume":"41","author":"Martin-Storey","journal-title":"Sleep"},{"key":"R22","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmedr.2017.07.008","article-title":"Dimensions of sexual orientation and sleep disturbance among young adults","volume":"8","author":"Fricke","journal-title":"Prev Med Rep"},{"key":"R23","doi-asserted-by":"publisher","DOI":"10.2147\/PRBM.S186586","article-title":"Role of sleep quality in mediating the relationship between sexual minority status and suicidal behavior among Chinese adolescents","volume":"11","author":"Huang","journal-title":"Psychol Res Behav Manag"},{"issue":"12","key":"R24","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-017067","article-title":"Is sexual minority status associated with poor sleep quality among adolescents? Analysis of a national cross-sectional survey in Chinese adolescents","volume":"7","author":"Li","journal-title":"BMJ Open"},{"key":"R25","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2021.08.075","article-title":"Sexual orientation and sleep problem among Chinese college students: mediating roles of interpersonal problems and depressive symptoms","volume":"295","author":"Wu","journal-title":"J Affect Disord"},{"issue":"7","key":"R26","doi-asserted-by":"publisher","first-page":"3053","DOI":"10.1007\/s10508-021-01981-2","article-title":"Differential impact of experienced and anticipated discrimination on sleep and health among sexual minorities","volume":"50","author":"Chan","journal-title":"Arch Sex Behav"},{"key":"R27","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2021.710575","article-title":"The holistic health status of Chinese homosexual and bisexual adults: a scoping review","volume":"9","author":"Wu","journal-title":"Front Public Health"},{"issue":"4","key":"R28","doi-asserted-by":"publisher","first-page":"263","DOI":"10.1089\/lgbt.2022.0119","article-title":"Mapping the scientific literature on health needs of women with same-sex attraction in Mainland China: a scoping review","volume":"10","author":"Wei","journal-title":"LGBT Health"},{"issue":"5","key":"R29","doi-asserted-by":"publisher","first-page":"1304","DOI":"10.1016\/j.chest.2019.12.002","article-title":"Physical and social environment relationship with sleep health and disorders","volume":"157","author":"Billings","journal-title":"Chest"},{"issue":"4","key":"R30","doi-asserted-by":"publisher","first-page":"417","DOI":"10.1016\/j.sleh.2021.05.005","article-title":"Influence of socioeconomic status on objective sleep measurement: a systematic review and meta-analysis of actigraphy studies","volume":"7","author":"Etindele Sosso","journal-title":"Sleep Health"},{"issue":"3","key":"R31","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1016\/j.smrv.2009.07.006","article-title":"Mortality associated with short sleep duration: the evidence, the possible mechanisms, and the future","volume":"14","author":"Grandner","journal-title":"Sleep Med Rev"},{"key":"R32","doi-asserted-by":"crossref","unstructured":"Grandner MA . Social-ecological model of sleep health. In: Grandner MA , editor. Sleep and Health. Academic Press; 2019:45-53. [doi: 10.1016\/B978-0-12-815373-4.00005-8]","DOI":"10.1016\/B978-0-12-815373-4.00005-8"},{"issue":"4","key":"R33","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1007\/s10865-020-00189-4","article-title":"Social-ecological considerations for the sleep health of rural mothers","volume":"44","author":"Fischer","journal-title":"J Behav Med"},{"key":"R34","unstructured":"Li S . Nonrestorative sleep: its evaluation, associated factors and impact [Thesis]. The University of Hong Kong; 2021. URL: https:\/\/hub.hku.hk\/handle\/10722\/306966 [Accessed 13-01-2025]"},{"key":"R35","doi-asserted-by":"crossref","unstructured":"He S Taylor BV Thakur NP Chakravorty S . Sleep and alcohol use. In: Grandner MA , editor. Sleep and Health. Academic Press; 2019:269-281. [doi: 10.1016\/B978-0-12-815373-4.00021-6]","DOI":"10.1016\/B978-0-12-815373-4.00021-6"},{"issue":"4","key":"R36","doi-asserted-by":"publisher","first-page":"539","DOI":"10.1111\/acer.12006","article-title":"Alcohol and sleep I: effects on normal sleep","volume":"37","author":"Ebrahim","journal-title":"Alcohol Clin Exp Res"},{"key":"R37","doi-asserted-by":"publisher","DOI":"10.1016\/j.drugalcdep.2020.108259","article-title":"Alcohol consumption and incidence of sleep disorder: a systematic review and meta-analysis of cohort studies","volume":"217","author":"Hu","journal-title":"Drug Alcohol Depend"},{"key":"R38","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2017.09.011","article-title":"Transitioning from adequate to inadequate sleep duration associated with higher smoking rate and greater nicotine dependence in a population sample","volume":"77","author":"Patterson","journal-title":"Addict Behav"},{"key":"R39","doi-asserted-by":"crossref","unstructured":"Patterson F Ashare R . Improved sleep as an adjunctive treatment for smoking cessation. In: Grandner MA , editor. Sleep and Health. Academic Press; 2019:283-301. [doi: 10.1016\/B978-0-12-815373-4.00022-8]","DOI":"10.1016\/B978-0-12-815373-4.00022-8"},{"key":"R40","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2021.101428","article-title":"Sleep and social relationships in healthy populations: a systematic review","volume":"57","author":"Gordon","journal-title":"Sleep Med Rev"},{"issue":"5","key":"R41","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1016\/j.jpsychores.2010.04.014","article-title":"Social determinants of self-reported sleep problems in South Korea and Taiwan","volume":"69","author":"Nomura","journal-title":"J Psychosom Res"},{"issue":"8","key":"R42","doi-asserted-by":"publisher","first-page":"787","DOI":"10.1037\/hea0000628","article-title":"Social support and sleep: a meta-analysis","volume":"37","author":"Kent de Grey","journal-title":"Health Psychol"},{"issue":"1","key":"R43","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1177\/1090198119871331","article-title":"Exploring the relationship between social support and sleep","volume":"47","author":"Krause","journal-title":"Health Educ Behav"},{"issue":"1-2","key":"R44","doi-asserted-by":"publisher","first-page":"631","DOI":"10.1016\/j.psychres.2014.08.029","article-title":"Social relationships play a role in sleep status in Chinese undergraduate students","volume":"220","author":"Jin","journal-title":"Psychiatry Res"},{"issue":"1","key":"R45","doi-asserted-by":"publisher","first-page":"110","DOI":"10.1016\/j.sleh.2019.08.013","article-title":"Individuals\u2019 perceptions of social support from family and friends are associated with lower risk of sleep complaints and short sleep duration","volume":"6","author":"Mesas","journal-title":"Sleep Health"},{"issue":"2","key":"R46","doi-asserted-by":"publisher","first-page":"248","DOI":"10.1177\/0022146512446642","article-title":"Family relationships and troubled sleep among U.S. adults: examining the influences of contact frequency and relationship quality","volume":"53","author":"Ailshire","journal-title":"J Health Soc Behav"},{"issue":"1","key":"R47","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1037\/ort0000117","article-title":"Social support networks among diverse sexual minority populations","volume":"86","author":"Frost","journal-title":"Am J Orthopsychiatry"},{"key":"R48","doi-asserted-by":"crossref","unstructured":"Jackson CL Gaston SA . The impact of environmental exposures on sleep. In: Grandner MA , editor. Sleep and Health. Academic Press; 2019:85-103. [doi: 10.1016\/B978-0-12-815373-4.00008-3]","DOI":"10.1016\/B978-0-12-815373-4.00008-3"},{"key":"R49","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2017.04.014","article-title":"Social support from the closest person and sleep quality in later life: evidence from a British birth cohort study","volume":"98","author":"Stafford","journal-title":"J Psychosom Res"},{"issue":"9596","key":"R50","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","article-title":"The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies","volume":"370","author":"von Elm","journal-title":"Lancet"},{"issue":"3","key":"R51","doi-asserted-by":"publisher","first-page":"508","DOI":"10.1207\/s15327752jpa6803_4","article-title":"Structural equation modeling: basic concepts and applications in personality assessment research","volume":"68","author":"Crowley","journal-title":"J Pers Assess"},{"issue":"1","key":"R52","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1207\/S15328007SEM1001_6","article-title":"Revisiting sample size and number of parameter estimates: some support for the N:q hypothesis","volume":"10","author":"Jackson","journal-title":"Struct Equ Modeling"},{"issue":"4","key":"R53","doi-asserted-by":"publisher","first-page":"362","DOI":"10.1080\/10401330701542685","article-title":"How to use structural equation modeling in medical education research: a brief guide","volume":"19","author":"Violato","journal-title":"Teach Learn Med"},{"issue":"522","key":"R54","doi-asserted-by":"publisher","first-page":"755","DOI":"10.1080\/01621459.2017.1285775","article-title":"Hidden population size estimation from respondent-driven sampling: a network approach","volume":"113","author":"Crawford","journal-title":"J Am Stat Assoc"},{"key":"R55","doi-asserted-by":"publisher","DOI":"10.1177\/2050312119829983","article-title":"Maximizing respondent-driven sampling field procedures in the recruitment of sexual minorities for health research","volume":"7","author":"Hequembourg","journal-title":"SAGE Open Med"},{"key":"R56","doi-asserted-by":"publisher","DOI":"10.2196\/42203","article-title":"Quality of life and mental health of Chinese sexual and gender minority women and cisgender heterosexual women: cross-sectional survey and mediation analysis","volume":"9","author":"Wu","journal-title":"JMIR Public Health Surveill"},{"issue":"1","key":"R57","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1186\/s12955-019-1251-5","article-title":"The mediating role of sleep quality in the association between nocturia and health-related quality of life","volume":"17","author":"Choi","journal-title":"Health Qual Life Outcomes"},{"issue":"8","key":"R58","doi-asserted-by":"publisher","first-page":"1943","DOI":"10.1007\/s11136-005-4346-x","article-title":"Psychometric evaluation of the Chinese version of the Pittsburgh Sleep Quality Index (CPSQI) in primary insomnia and control subjects","volume":"14","author":"Tsai","journal-title":"Qual Life Res"},{"issue":"2","key":"R59","first-page":"103","volume":"29","author":"Liu","journal-title":"Chin J Neuro Psychiatry"},{"issue":"2","key":"R60","first-page":"98","volume":"4","author":"Xiao","journal-title":"J Clin Psychol Med (Chin)"},{"key":"R61","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2021.625506","article-title":"Learning burnout: evaluating the role of social support in medical students","volume":"12","author":"Zhang","journal-title":"Front Psychol"},{"issue":"5","key":"R62","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0233831","article-title":"Social support and mental health among health care workers during coronavirus disease 2019 outbreak: a moderated mediation model","volume":"15","author":"Hou","journal-title":"PLoS ONE"},{"issue":"1","key":"R63","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0228152","article-title":"The relationship between psychological health and social support: evidence from physicians in China","volume":"15","author":"Sun","journal-title":"PLoS One"},{"key":"R64","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2288-12-37","article-title":"Quality of life of Chinese urban community residents: a psychometric study of the mainland Chinese version of the WHOQOL-BREF","volume":"12","author":"Xia","journal-title":"BMC Med Res Methodol"},{"issue":"4","key":"R65","doi-asserted-by":"publisher","first-page":"945","DOI":"10.1007\/s11136-016-1413-4","article-title":"Mental health and health-related quality of life of Chinese college students who were the victims of dating violence","volume":"26","author":"Choi","journal-title":"Qual Life Res"},{"issue":"1","key":"R66","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/s0895-4356(99)00123-7","article-title":"Validation of the United States\u2019 version of the World Health Organization Quality of Life (WHOQOL) instrument","volume":"53","author":"Bonomi","journal-title":"J Clin Epidemiol"},{"issue":"2","key":"R67","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1023\/B:QURE.0000018486.91360.00","article-title":"The World Health Organization\u2019s WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group","volume":"13","author":"Skevington","journal-title":"Qual Life Res"},{"key":"R68","doi-asserted-by":"crossref","unstructured":"Cohen J . Statistical Power Analysis for the Behavioral Sciences. Routledge; 2013. ISBN: 9781134742707","DOI":"10.4324\/9780203771587"},{"issue":"1","key":"R69","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1080\/10705519909540118","article-title":"Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives","volume":"6","author":"Hu","journal-title":"Struct Equ Modeling"},{"issue":"2","key":"R70","doi-asserted-by":"publisher","first-page":"130","DOI":"10.1037\/\/1082-989X.1.2.130","article-title":"Power analysis and determination of sample size for covariance structure modeling","volume":"1","author":"MacCallum","journal-title":"Psychol Methods"},{"key":"R71","unstructured":"Muth\u00e9n B Muth\u00e9n L . Mplus 86 software. URL: https:\/\/www.statmodel.com\/index.shtml [Accessed 13-01-2025]"},{"issue":"7","key":"R72","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/s00406-024-01764-5","article-title":"The prevalence of poor sleep quality in the general population in China: a meta-analysis of epidemiological studies","volume":"274","author":"Chen","journal-title":"Eur Arch Psychiatry Clin Neurosci"},{"issue":"6","key":"R73","doi-asserted-by":"publisher","first-page":"587","DOI":"10.1016\/j.sleh.2022.09.006","article-title":"Association between discrimination and poor sleep health outcomes among 2192 South Korean gay, lesbian, and bisexual adults: a nationwide cross-sectional survey","volume":"8","author":"Choo","journal-title":"Sleep Health"},{"issue":"1-2","key":"R74","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1007\/s10464-013-9584-4","article-title":"LGBT community, social network characteristics, and smoking behaviors in young sexual minority women","volume":"52","author":"Johns","journal-title":"Am J Community Psychol"},{"issue":"3","key":"R75","doi-asserted-by":"publisher","first-page":"546","DOI":"10.1111\/add.14819","article-title":"Functional and structural social support, substance use and sexual orientation from a nationally representative sample of US adults","volume":"115","author":"Kahle","journal-title":"Addiction"},{"issue":"4","key":"R76","doi-asserted-by":"publisher","first-page":"316","DOI":"10.1016\/j.sleh.2016.07.003","article-title":"Poor sleep health and its association with mental health, substance use, and condomless anal intercourse among gay, bisexual, and other men who have sex with men","volume":"2","author":"Duncan","journal-title":"Sleep Health"},{"key":"R77","doi-asserted-by":"publisher","DOI":"10.1016\/j.copsyc.2019.03.007","article-title":"Alcohol and sleep-related problems","volume":"30","author":"He","journal-title":"Curr Opin Psychol"},{"issue":"1","key":"R78","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1111\/j.1365-2869.2012.01043.x","article-title":"Bidirectional associations between insomnia symptoms and unhealthy behaviours","volume":"22","author":"Haario","journal-title":"J Sleep Res"},{"issue":"5","key":"R79","doi-asserted-by":"publisher","first-page":"775","DOI":"10.17269\/s41997-020-00308-3","article-title":"Smoking and risk of sleep-related issues: a systematic review and meta-analysis of prospective studies","volume":"111","author":"Amiri","journal-title":"Can J Public Health"},{"key":"R80","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2021.07.012","article-title":"Smoking and incidence of insomnia: a systematic review and meta-analysis of cohort studies","volume":"198","author":"Hu","journal-title":"Public Health (Fairfax)"},{"issue":"1","key":"R81","doi-asserted-by":"publisher","first-page":"41","DOI":"10.1016\/j.sleh.2023.11.003","article-title":"Sexual minorities and sleep health: how does discrimination and stigma influence a sleep disorder diagnosis?","volume":"10","author":"Segovia","journal-title":"Sleep Health"},{"issue":"3","key":"R82","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1080\/15402002.2019.1591410","article-title":"Examining sleep duration and sleep health among sexual minority and heterosexual adults: findings from NHANES (2005-2014)","volume":"18","author":"Caceres","journal-title":"Behav Sleep Med"},{"key":"R83","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2023.10.004","article-title":"Temporal trends in sleep pattern among Chinese adults between 2010 and 2018: findings from five consecutive nationally representative surveys","volume":"225","author":"Chu","journal-title":"Public Health (Fairfax)"}],"container-title":["JMIR Public Health and Surveillance"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/publichealth.jmir.org\/2025\/1\/e53549","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T17:39:20Z","timestamp":1782841160000},"score":1,"resource":{"primary":{"URL":"https:\/\/publichealth.jmir.org\/2025\/1\/e53549"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,21]]},"references-count":83,"URL":"https:\/\/doi.org\/10.2196\/53549","relation":{},"ISSN":["2369-2960"],"issn-type":[{"value":"2369-2960","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,21]]},"article-number":"v11i1e53549"}}