Abnormal night sleep duration and poor sleep quality are independently and combinedly associated with elevated depressive symptoms in Chinese rural adults: Henan Rural Cohort

Purpose: Insomnia and short sleep duration have been associated with increased incidence of hypertension. However, the relationship between sleep loss and resistant hypertension (RH), has not been ascertained yet. Methods: 270 patients at first access to our Hypertension Outpatient Unit were enrolled. RH was defined according as office BP values >140/90 mmHg with 3 or more antihypertensive drugs, or controlled BP with 4 or more drugs, including a diuretic. Pittsburgh Sleep Quality Index (PSQI), and Beck Depression Inventory (BDI) were assessed. Poor sleep quality was defined as PSQI>5, mild-to-severe depressive symptoms as BDI score >10. Patients with self-reported sleep apneas or snoring were excluded (n=21). Results: Complete data were available for 234 patients (males 51%, mean age 58±13 years, BMI 26±5 kg/mq, antihypertensive treatment 84%, previous CV events 12%, diabetes 8%, smoking 15%, hypercholesterolemia 60%). Mean sleep duration was 6.4±1.6 hours, with a 49% prevalence of short sleep duration (<6 hours) and similar in both sexes. Conversely, women had higher PSQI scores (5.2 vs 3.6, p=0.03) and prevalence of poor sleep quality (46% vs 30% in men, p=0.01). Women showed also higher BDI scores (4.5 vs 1.8, p=0.006) and prevalence of depressive symptoms than men (20% vs 7%, p=0.003). RH patients (15%) had higher PSQI (5.8 vs 4.1, p=0.03), a difference shown in women (6.8 vs 4.8, p=0.04) but not in men (4.7 vs 3.5, p=0.37). The association between BDI score and RH showed a similar behavior (overall 3.6 vs 2.8, p=0.02; women 5.1 vs 3.7, p=0.03; men: 2.0 vs 1.9, p=0.53). In a multiple logistic regression analysis (including age, sex, obesity, diabetes, previous CV events, sleep duration, use of hypnotic drugs) poor sleep quality was independently associated with RH (OR 2.2, CI95% 1.1-5.3). However this relationship lost significance when also depressive symptoms were included in the model (p=0.12). Conclusions: Short sleep duration is highly prevalent in hypertensive patients. This condition is accompanied by poor sleep quality and depressive symptoms in women. Poor sleep quality is associated with a 2-fold higher probability of having RH. This association could be mediated by the presence of depressive symptoms.

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The Impact of Sleep Timing, Sleep Duration, and Sleep Quality on Depressive Symptoms and Suicidal Ideation amongst Japanese Freshmen: The EQUSITE Study

Sleep Disorders ◽

10.1155/2016/8737654 ◽

2016 ◽

Vol 2016 ◽

pp. 1-10 ◽

Cited By ~ 17

Author(s):

Atin Supartini ◽

Takanori Honda ◽

Nadzirah A. Basri ◽

Yuka Haeuchi ◽

Sanmei Chen ◽

...

Keyword(s):

Depressive Symptoms ◽

Suicidal Ideation ◽

Sleep Quality ◽

Sleep Duration ◽

Sleep Onset ◽

Poor Sleep ◽

Sleep Onset Latency ◽

Onset Latency ◽

Poor Sleep Quality ◽

The Impact

Aim. The aim of this study was to identify the impact of bedtime, wake time, sleep duration, sleep-onset latency, and sleep quality on depressive symptoms and suicidal ideation amongst Japanese freshmen.Methods. This cross-sectional data was derived from the baseline survey of the Enhancement of Q-University Students Intelligence (EQUSITE) study conducted from May to June, 2010. A total of 2,631 participants were recruited and completed the following self-reported questionnaires: the Pittsburgh Sleep Quality Index (PSQI), the Center for Epidemiologic Studies Depression Scale (CES-D), and the original Health Support Questionnaires developed by the EQUSITE study research team.Results. Of 1,992 participants eligible for analysis, 25.5% (n=507) reported depressive symptoms (CES-D total score ≥ 16), and 5.8% (n=115) reported suicidal ideation. The present study showed that late bedtime (later than 01:30), sleep-onset latency (≥30 minutes), and poor sleep quality showed a marginally significant association with depressive symptoms. Poor sleep quality was seen to predict suicidal ideation even after adjusting for depressive symptoms.Conclusion. The current study has important implications for the role of bedtime in the prevention of depressive symptoms. Improving sleep quality may prevent the development of depressive symptoms and reduce the likelihood of suicidal ideation.

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Associations of sleep quality and sleep duration with frailty and pre-frailty in an elderly population Rugao longevity and ageing study

BMC Geriatrics ◽

10.1186/s12877-019-1407-5 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 3

Author(s):

Xue-Hui Sun ◽

Teng Ma ◽

Shun Yao ◽

Ze-Kun Chen ◽

Wen-Dong Xu ◽

...

Keyword(s):

Sleep Quality ◽

Sleep Duration ◽

Sleep Disturbances ◽

Elderly Population ◽

Sleep Time ◽

Community Dwelling ◽

Poor Sleep ◽

Night Sleep ◽

Poor Sleep Quality ◽

Logistic Regression Models

Abstract Background Previous studies suggest that poor sleep quality or abnormal sleep duration may be associated with frailty. Here we test the associations of sleep disturbances with both frailty and pre-frailty in an elderly population. Methods Participants included 1726 community-dwelling elders aged 70–87 years. Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep disturbances. Frailty was defined using phenotype criteria. Logistic regression models were used to estimate odds ratio of the associations. Results The average PSQI score was 5.4 (SD, 3.1). Overall 43.6% of the participants had poor sleep quality (PSQI> 5), 8.2% had night sleep time ≤ 5 h, and 27.8% had night sleep time ≥ 9 h. The prevalence of frailty and pre-frailty was 9.2 and 52.8%, respectively. The proportions of PSQI> 5 increased with the severity of frailty status (robust: pre-frail: frail, 34.5%: 48%: 56.1%, P < 0.001). After adjustment for multiple potential confounders, poor sleep quality (PSQI> 5) was associated with higher odds of frailty (OR = 1.78, 95% CI 1.19–2.66) and pre-frailty (OR = 1.51, 95% CI 1.20–1.90). Sleep latency, sleep disturbance, and daytime dysfunction components of PSQI measurements were also associated with frailty and pre-frailty. In addition, sleep time 9 h/night was associated with higher odds of frailty and pre-frailty. Conclusions We provided preliminary evidences that poor sleep quality and prolonged sleep duration were associated with being frailty and pre-frailty in an elderly population aged 70–87 years. The associations need to be validated in other elderly populations.

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Anxiety and depressive symptoms are associated with poor sleep health during a period of COVID-19-induced nationwide lockdown: a cross-sectional analysis of adults in Jordan

BMJ Open ◽

10.1136/bmjopen-2020-041995 ◽

2020 ◽

Vol 10 (12) ◽

pp. e041995

Author(s):

Yazan A Al-Ajlouni ◽

Su Hyun Park ◽

Jude Alawa ◽

Ghaith Shamaileh ◽

Aziz Bawab ◽

...

Keyword(s):

Depressive Symptoms ◽

Sleep Quality ◽

Health Outcomes ◽

Sleep Duration ◽

Sleep Problem ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Short Sleep Duration ◽

Sleep Health ◽

Short Sleep

Background Jordan, a Middle Eastern country, declared a state of national emergency due to COVID-19 and a strict nationwide lockdown on 17 March 2020, banning all travel and movement around the country, potentially impacting mental health. This study sought to investigate the association between mental health (eg, anxiety and depressive symptoms) and sleep health among a sample of Jordanians living through a state of COVID-19-induced nationwide lockdown. Methods Using Facebook, participants (n=1240) in Jordan in March 2020 were recruited and direct to a web-based survey measuring anxiety (items from General Anxiety Disorder 7-item (GAD-7) scale instrument), depressive symptoms (items from Center for Epidemiologic Studies Depression Scale), sleep health (items from the Pittsburgh Sleep Quality Index) and sociodemographic. A modified Poisson regression model with robust error variance. Adjusted prevalence ratios (aPRs) and 95% CIs were estimated to examine how anxiety and depressive symptoms may affect different dimensions of sleep health: (1) poor sleep quality, (2) short sleep duration, (3) encountering sleep problems. Results The majority of participants reported having experienced mild (33.8%), moderate (12.9%) or severe (6.3%) levels of anxiety during lockdown, and nearly half of respondents reported depressive symptoms during lockdown. Similarly, over 60% of participants reported having experienced at least one sleep problem in the last week, and nearly half reported having had short sleep duration. Importantly, anxiety was associated with poor sleep health outcomes. For example, corresponding to the dose–response relationship between anxiety and sleep health outcomes, those reporting severe anxiety were the most likely to experience poor sleep quality (aPR =8.95; 95% CI=6.12 to 13.08), short sleep duration (aPR =2.23; 95% CI=1.91 to 2.61) and at least one problem sleep problem (aPR=1.73; 95% CI=1.54 to 1.95). Moreover, depressive symptoms were also associated with poor sleep health outcomes. As compared with scoring in the first quartile, scoring fourth quartile was associated with poor sleep quality (aPR=11.82; 95% CI=6.64 to 21.04), short sleep duration (aPR=1.87; 95% CI=1.58 to 2.22), and experiencing at least one sleep problem (aPR=1.90; 95% CI=1.66 to 2.18). Conclusions Increased levels of anxiety and depressive symptoms can negatively influence sleep health among a sample of Jordanian adults living in a state of COVID-19-induced nationwide lockdown.

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Sleep among gender minority adolescents

SLEEP ◽

10.1093/sleep/zsaa185 ◽

2020 ◽

Author(s):

Jessica C Levenson ◽

Brian C Thoma ◽

Jessica L Hamilton ◽

Sophia Choukas-Bradley ◽

Rachel H Salk

Keyword(s):

Depressive Symptoms ◽

Sleep Quality ◽

Sleep Duration ◽

Online Survey ◽

Sleep Problems ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Gender Minority ◽

Minority Adolescents ◽

Inadequate Sleep

Abstract Study Objectives Stigmatized youth experience poorer sleep than those who have not experienced stigma. However, no studies have examined the sleep of gender minority adolescents (GMAs). Examining sleep disparities between GMAs and non-GMAs is critical because poor sleep is associated with mental health outcomes experienced disproportionately by GMAs. We examined sleep duration, sleep problems, and sleep quality among our sample and compared these parameters between GMAs and non-GMAs. Methods Adolescents aged 14–18 years (n = 1,027 GMA, n = 329 heterosexual non-GMA, n = 415 sexual minority non-GMA; mean age = 16 years; 83% female sex at birth) completed a cross-sectional online survey, reporting sex assigned at birth and current gender identity, sleep duration, sleep problems (too much/too little sleep and inadequate sleep), sleep quality, and depressive symptoms. Results Accounting for demographic covariates, GMAs were more likely to report inadequate sleep and shorter sleep duration and had higher odds of reporting poor sleep quality and getting too little/too much sleep than heterosexual non-GMAs. After also adjusting for depressive symptoms, the finding that GMAs more often reported poor sleep quality remained significant. Conclusions This first large, nationwide survey of sleep among GMAs suggests that GMAs may be more likely to have poor sleep than non-GMAs. The significance of our results was reduced when adjusting for depressive symptoms, suggesting that poorer sleep may occur in the context of depression for GMAs. Future work should include objective measures of sleep, examine the emergence of sleep disparities among GMAs and non-GMAs, and explore pathways that increase risk for poor sleep among GMAs.

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Association Between Sleep and Motoric Cognitive Risk Syndrome Among Community-Dwelling Older Adults: Results From the China Health and Retirement Longitudinal Study

Frontiers in Aging Neuroscience ◽

10.3389/fnagi.2021.774167 ◽

2021 ◽

Vol 13 ◽

Author(s):

Weihao Xu ◽

Anying Bai ◽

Xin Huang ◽

Yinghui Gao ◽

Lin Liu

Keyword(s):

Older Adults ◽

Longitudinal Study ◽

Sleep Quality ◽

Sleep Duration ◽

Multivariate Logistic Regression Analysis ◽

Community Dwelling ◽

Poor Sleep ◽

Night Sleep ◽

Poor Sleep Quality ◽

Cognitive Risk

Background: Sleep is increasingly recognized as an important lifestyle contributor to health; however, its relationship with Motoric cognitive risk syndrome (MCR) is still unclear. The present study aimed to examine the associations between sleep duration, sleep quality, and MCR among community-dwelling Chinese older adults.Methods: We recruited 5,387 participants aged ≥60 years from the China Health and Retirement Longitudinal Study (CHARLS). Sleep-related variables including night sleep duration and sleep quality were assessed via self-reported questionnaires. MCR syndrome was defined as cognitive complaints and slow gait speed without dementia or impaired mobility. Multivariate logistic regression analysis was performed to explore the associations between sleep-related variables and MCR after controlling for all potential confounders including demographic characteristics, lifestyle factors, and comorbidities.Results: We found that sleep duration was significantly associated with MCR, and the multivariate-adjusted odds ratios (OR) were highest for those with the shortest (<6 h OR = 1.55, 95% CI = 1.18–2.04) and longest (≥10 h OR = 1.73, 95% CI = 1.03–2.91) sleep durations. Moreover, an increasing frequency of self-perceived poor sleep quality was significantly associated with MCR in the adjusted model (3–4 days OR = 1.58, 95% CI = 1.16–2.17; 5–7 days OR = 1.81, 95% CI = 1.37–2.40).Conclusions: Our study indicated an inverted U-shaped association between night sleep duration and MCR. Poor sleep quality was also associated with higher odds of MCR in community-dwelling Chinese elders. Longitudinal studies with a larger population size are needed to establish causality in the future and further explore potential action mechanisms.

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Association of severity of depressive symptoms with sleep quality, social support and stress among Pakistani medical and dental students: A cross-sectional study

Global Psychiatry ◽

10.2478/gp-2019-0019 ◽

2019 ◽

Vol 2 (2) ◽

pp. 211-220

Author(s):

Ahmed Waqas ◽

Aqsa Iftikhar ◽

Zahra Malik ◽

Kapil Kiran Aedma ◽

Hafsa Meraj ◽

...

Keyword(s):

Social Support ◽

Depressive Symptoms ◽

Medical Students ◽

Sleep Quality ◽

Severe Depression ◽

Dental Students ◽

Poor Sleep ◽

Poor Sleep Quality ◽

Cross Sectional ◽

Medical And Dental Students

AbstractObjectivesThis study has been designed to elucidate the prevalence of stress, depression and poor sleep among medical students in a Pakistani medical school. There is a paucity of data on social support among medical students in Pakistan; an important predictor of depressive symptoms. Therefore, this study was also aimed to demonstrate the direct and indirect impact of social support in alleviating depressive symptoms in the study sample.MethodsThis observational cross-sectional study was conducted in Lahore, Pakistan, where a total of 400 students at a medical school were approached between 1st January to 31st March 2018 to participate in the study. The study sample comprised of medical and dental students enrolled at a privately financed Pakistani medical and dental school. The participants responded to a self-administered survey comprising of five parts: a) demographics, b) Pittsburgh Sleep Quality Index (PSQI), c) Patient Health Questionnaire-9 (PHQ-9), d) Multidimensional Scale of Perceived Social Support (MSPSS) and e) Perceived Stress Scale-4 (PSS-4). All data were analysed using SPSS v. 20. Linear regression analysis was used to reveal the predictors of depression.ResultsIn total, 353 medical students participated, yielding a response rate of 88.25%. Overall, poor sleep quality was experienced by 205 (58.1%) students. Mild to severe depression was reported by 83% of the respondents: mild depression by 104 (29.5%), moderate depression by 104 (29.5%), moderately severe depression by 54 (15.3%) and severe depression by 31 (8.8%) respondents. Subjective sleep quality, sleep latency, daytime dysfunction and stress levels were significantly associated with depression symptoms. Social support was not significantly associated with depressive symptoms in the regression model (Beta = -0.08, P < 0.09); however, it acted as a significant mediator, reducing the strength of the relationship between depressive symptoms and sleep quality and stress.ConclusionsAccording to our study, a large proportion of healthcare (medical and dental) students were found to be suffering from mild to moderate depression and experienced poor sleep quality. It is concluded that social support is an important variable in predicting depressive symptomatology by ameliorating the effects of poor sleep quality and high stress levels.

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The prevalence and risk factors for depressive symptoms in frontline nurses under COVID-19 pandemic based on a large cross-sectional study using the propensity score-matched method

BMC Psychiatry ◽

10.1186/s12888-021-03143-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hongyan Wang ◽

Xiaoling Dai ◽

Zichuan Yao ◽

Xianqing Zhu ◽

Yunzhong Jiang ◽

...

Keyword(s):

Risk Factors ◽

Depressive Symptoms ◽

Sleep Quality ◽

Psychological Capital ◽

Cross Sectional Study ◽

Poor Sleep ◽

Sectional Study ◽

Poor Sleep Quality ◽

Related Factors ◽

Cross Sectional

Abstract Introduction To explore the prevalence of depressive symptoms and the associated risk factors in frontline nurses under COVID-19 pandemic. Methods This cross-sectional study was conducted from February 20, 2020 to March 20, 2020 and involved 562 frontline nurses. The effective response rate was 87.68%. After propensity score matched, there were 498 participants left. Extensive characteristics, including demographics, dietary habits, life-related factors, work-related factors, and psychological factors were collected based on a self-reported questionnaire. Specific scales measured the levels of sleep quality, physical activity, depressive symptoms, perceived organization support and psychological capital. Adjusted odds ratios and 95% confidence intervals were determined by binary paired logistic regression. Results Of the nurses enrolled in the study, 50.90% had depressive symptoms. Three independent risk factors were identified: poor sleep quality (OR = 1.608, 95% CI: 1.384–1.896), lower optimism of psychological capital (OR = 0.879, 95% CI: 0.805–0.960) and no visiting friend constantly (OR = 0.513, 95% CI: 0.286–0.920). Conclusions This study revealed a considerable high prevalence of depressive symptoms in frontline nurses during the COVID-19 outbreak, and identified three risk factors, which were poor sleep quality, lower optimism of psychological capital, and no visiting friend constantly. Protecting mental health of nurses is important for COVID-19 pandemic control and their wellbeing. These findings enrich the existing theoretical model of depression and demonstrated a critical need for additional strategies that could address the mental health in frontline nurses for policymakers.

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Association between pet ownership and sleep in the Swedish CArdioPulmonary bioImage Study (SCAPIS)

Scientific Reports ◽

10.1038/s41598-021-87080-7 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Lieve T. van Egmond ◽

Olga E. Titova ◽

Eva Lindberg ◽

Tove Fall ◽

Christian Benedict

Keyword(s):

Sleep Quality ◽

Sleep Duration ◽

Odds Ratio ◽

Poor Sleep ◽

Pet Ownership ◽

Poor Sleep Quality ◽

Short Sleep Duration ◽

Dog Walking ◽

Dog Ownership ◽

Using Data

AbstractPreliminary findings suggest that pets may impact the owner’s sleep. By using data from the Swedish CArdioPulmonary bIoimage Study (SCAPIS) cohort, we aimed to investigate the association of pet ownership with the following self-reported sleep outcomes in 3788 to 4574 participants: (i) achieving the recommended daily sleep duration for adults (i.e., at least 7 h per day); (ii) sleep quality as measured by the Pittsburgh Sleep Quality Index (a score of > 5 indicating poor sleep quality); and (iii) difficulty falling or staying asleep. Sleep metrics were not associated with pet ownership, dog ownership, and dog walking when controlling the logistic regression for possible confounders (e.g., shift work, lack of social interaction, and chronic stress). In contrast, cat ownership was associated with a higher odds ratio of failing to achieve the recommended duration of 7 h of sleep per day (adjusted odds ratio [95% CI]:1.18 [1.02, 1.37] versus non-cat owners). Our findings suggest that certain pet groups might have a more significant impact on the owner’s sleep than others. As the observed association between cat ownership and short sleep duration might be a chance finding, this observation should be seen as hypothesis-generating only.

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Left superior temporal sulcus morphometry mediates the impact of anxiety and depressive symptoms on sleep quality in healthy adults

Social Cognitive and Affective Neuroscience ◽

10.1093/scan/nsab012 ◽

2021 ◽

Author(s):

Yanlin Wang ◽

Ping Jiang ◽

Shi Tang ◽

Lu Lu ◽

Xuan Bu ◽

...

Keyword(s):

Depressive Symptoms ◽

Sleep Quality ◽

Sleep Problems ◽

Superior Temporal Sulcus ◽

Healthy Adults ◽

Poor Sleep ◽

Emotional Symptoms ◽

Neural Basis ◽

Poor Sleep Quality ◽

The Impact

Abstract Anxiety and depressive symptoms may predispose individuals to sleep disturbance. Understanding how these emotional symptoms affect sleep quality, especially the underlying neural basis, could support the development of effective treatment. The aims of the present study were therefore to investigate potential changes in brain morphometry associated with poor sleep quality and whether this structure played a mediating role between the emotional symptoms and sleep quality. One hundred and forty-one healthy adults (69 women, mean age = 26.06 years, SD = 6.36 years) were recruited. A structural magnetic resonance imaging investigation was performed, and self-reported measures of anxiety, depressive symptoms and sleep quality were obtained for each participant. Whole-brain regression analysis revealed that worse sleep quality was associated with thinner cortex in left superior temporal sulcus (STS). Furthermore, the thickness of left STS mediated the association between the emotional symptoms and sleep quality. A subsequent commonality analysis showed that physiological component of the depressive symptoms had the greatest influence on sleep quality. In conclusion, thinner cortex in left STS may represent a neural substrate for the association between anxiety and depressive symptoms and poor sleep quality and may thus serve as a potential target for neuromodulatory treatment of sleep problems.

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