Maternal Depressive Symptoms, Sleep, and Odds of Spontaneous Early Birth: Implications for Racial Inequities in Birth Outcomes

SLEEP ◽  
2021 ◽  
Author(s):  
Lisa M Christian ◽  
Shannon Webber ◽  
Shannon Gillespie ◽  
Anna M Strahm ◽  
Jonathan Schaffir ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Depressive Symptoms ◽  
Black Women ◽  
Sleep Quality ◽  
White Women ◽  
Psychosocial Assessment ◽  
Poor Sleep ◽  
Subjective Sleep Quality ◽  
Subjective Sleep

Abstract Study Objectives Delivery prior to full term affects 37% of US births, including ~400,000 preterm births (<37 weeks) and >1,000,000 early term births (37-38 weeks). Approximately 70% of cases of shortened gestation are spontaneous - without medically-indicated cause. Elucidation of modifiable behavioral factors would have considerable clinical impact. Methods This study examined the role of depressive symptoms and sleep quality in predicting the odds of spontaneous shortened gestation among 317 women (135 Black, 182 White) who completed psychosocial assessment in mid-pregnancy. Results Adjusting for key covariates, Black women had 1.89 times higher odds of spontaneous shortened gestation compared to White women (OR (95% CI) = 1.89 (1.01, 3.53), p=0.046). Women who reported only poor subjective sleep quality (PSQI > 6) or only elevated depressive symptoms (CES-D ≥ 16) exhibited no statistically significant differences in odds of spontaneous shortened gestation compared to those with neither risk factor. However, women with comorbid poor sleep and depressive symptoms exhibited markedly higher odds of spontaneous shortened gestation than those with neither risk factor [39.2% versus 15.7%, [OR (95% CI) = 2.69 (1.27, 5.70), p = 0.01]. A higher proportion of Black women met criteria for both risk factors (23% of Black women versus 11% of White women; p=0.004), with a lower proportion experiencing neither risk factor (40.7% of Black versus 64.3% of White women; p < 0.001). Conclusions Additive effects of poor subjective sleep quality and depressive symptoms were observed with markedly higher odds of spontaneous shortened gestation among women with both risk factors. Racial inequities in rates of comorbid exposure corresponded with inequities in shortened gestation. Future empirical studies and intervention efforts should consider the interactive effects of these commonly co-morbid exposures.

Depressive Symptoms, Subjective Cognitive Decline, and Subjective Sleep Quality Are Associated with Slips and Falls: Data from the Community Health Survey in Korean Adults

Gerontology ◽  
2021 ◽  
pp. 1-11
Author(s):  
Ji Hee Kim ◽  
Joon Ho Song ◽  
Jee Hye Wee ◽  
Jung Woo Lee ◽  
Hyo Geun Choi
Keyword(s):  
Risk Factors ◽  
Depressive Symptoms ◽  
Sleep Quality ◽  
Cognitive Decline ◽  
Sleep Problems ◽  
Subjective Cognitive Decline ◽  
Poor Sleep ◽  
Subjective Sleep Quality ◽  
Subjective Sleep ◽  
Risk Factors For Falls

<b><i>Background:</i></b> Identifying the risk factors for falls among the elderly population is arguably one of the most imperative public health issues in the current aging society. <b><i>Objectives:</i></b> This study aimed to determine the associations between depressive symptoms, subjective cognitive decline (SCD), and poor subjective sleep quality and the risk of slips/falls in a Korean older population. <b><i>Methods:</i></b> This cross-sectional study involved 228,340 elderly individuals living in Korea. Measurements included self-reported depressive symptoms, SCD, and self-reported sleep quality. The risk of slips/falls was dichotomized depending on whether slips/falls had occurred during the past year, and the associations between different risk factors and slips/falls were explored. Multiple logistic regression was used to obtain the odds ratios (ORs) and 95% confidence intervals (CIs). Complex sampling methods were used to estimate the weighted value of each participant. <b><i>Results:</i></b> The risk of slips/falls was significantly associated with high levels of depressive symptoms (adjusted OR 1.06, 95% CI: 1.05–1.07) and SCD (adjusted OR 1.33, 95% CI: 1.19–1.50). Regarding each sleep quality component, the adjusted ORs for slips/falls were 1.85 for very poor sleep quality, 1.49 for long sleep latency, 1.04 for &#x3c;5 h of sleep duration, 1.32 for low sleep efficiency, 2.78 for high sleep disturbance, 1.52 for the use of sleep medication ≥3 times a week, and 1.82 for high daytime dysfunction due to sleep problems compared to the respective good sleep conditions. <b><i>Conclusions:</i></b> Our results demonstrated that depressive symptoms, SCD, and poor subjective sleep quality are independent factors affecting the occurrence of slips/falls. Thus, efforts to manage depressive symptoms and cognitive decline early and to improve sleep quality can be an alternative strategy to decrease the likelihood of falls.

scholarly journals The influence of subjective sleep quality on the association between eveningness and depressive symptoms.

2018 ◽  
Author(s):  
Charlotte Mary Horne ◽  
Ray Norbury
Keyword(s):  
Depressive Symptoms ◽  
Sleep Quality ◽  
Mediation Analysis ◽  
Depression Scale ◽  
Well Being ◽  
Poor Sleep ◽  
Subjective Sleep Quality ◽  
Subjective Sleep ◽  
Increased Risk ◽  
Healthy Participants

Increasing evidence suggests that eveningness is associated with increased risk for depression. Eveningness, however, is also associated with poor sleep quality and the unique role of eveningness in depressive symptomatology remains to be elucidated. The goal of the current study, therefore, was to examine the inter-relationships between eveningness, subjective sleep quality and depressive symptoms in healthy participants free of current or previous depression and sleep disorder. Here, 167 healthy participants (mean age 24.16, 129/38 females/males) completed the reduced Morningness-Eveningness Questionnaire (rMEQ), the Pittsburgh Sleep Quality Index (PSQI) and the Centre for Epidemiological Studies Depression Scale (CES-D). Bootstrap mediation analysis for a simple mediation model including rMEQ, PSQI and CES-D was applied. Eveningness was associated with increased depressive symptoms and mediation analysis showed that this relationship was partly mediated by sleep quality. Our results suggest that indicators of depression observed in evening-type individuals cannot be attributed exclusively to disturbed sleep. We suggest that interventions that target both sleep quality and dysfunctionl cognitive styles would be optimal to promote well-being in evening-type individuals.

scholarly journals Poor Sleep and Decision-Making Disturbance Are Associated With Suicidal Ideation in Pre-natal Depression

2021 ◽  
Vol 12 ◽  
Author(s):  
Ciqing Bao ◽  
Ling Xu ◽  
Weina Tang ◽  
Shiyu Sun ◽  
Wenmiao Zhang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Decision Making ◽  
Suicidal Ideation ◽  
Sleep Quality ◽  
Sleep Disturbance ◽  
Poor Sleep ◽  
Healthy Controls ◽  
Subjective Sleep Quality ◽  
Subjective Sleep ◽  
Post Natal Depression

Although many risk factors for suicidal ideation have been identified, few studies have focused on suicidal ideation and pre-natal depression. The purpose was to investigate the relationship between decision-making (DM) dysfunction and sleep disturbance on suicidal ideation in pre-natal depression. Participants included 100 women in the third trimester of pregnancy, including pregnant women with pre-natal depression who had recent suicidal ideation (n = 30), pre-natal depression without SI (n = 35) and healthy controls (n = 35). The Iowa Gambling Task (IGT) was used to evaluate the DM function and the Pittsburgh Sleep Quality Index (PSQI) was used to assess the sleep index. The Edinburgh Post-natal Depression Scale (EPDS) was used to assess suicidal ideation and the seriousness of depression. Overall, the two groups with pre-natal depression showed worse sleep quality and decreased DM function compared with healthy controls. The pre-natal depression with suicidal ideation group showed a significantly higher score in subjective sleep quality and a lower score in block 5 of IGT than the pre-natal depression without suicidal ideation group. Further correlation analysis showed that suicidal ideation positively correlated with subjective sleep quality, sleep duration, and daytime function, and negatively correlated with IGT scores. Sleep disturbance and impaired DM function may be risk factors for suicidal ideation in pre-natal depression.

scholarly journals Subjective sleep quality and association with depression syndrome, chronic diseases and health-related physical fitness in the middle-aged and elderly

2020 ◽  
Author(s):  
Min-Fang Hsu ◽  
Kang-Yun Lee ◽  
Tsung-Ching Lin ◽  
Wen-Te Liu ◽  
Shu-Chuan Ho
Keyword(s):  
Depressive Symptoms ◽  
Physical Fitness ◽  
Sleep Quality ◽  
Chronic Diseases ◽  
Poor Sleep ◽  
Middle Aged ◽  
Poor Sleep Quality ◽  
Subjective Sleep Quality ◽  
Subjective Sleep ◽  
Health Related

Abstract Background: As a complex phenomenon, sleep quality is difficult to objectively define and measure, and multiple factors related to sleep quality, such as age, lifestyle, physical activity, and physical fitness, feature prominently in older adult populations. The aim of the present study was to evaluate subjective sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and to associate sleep quality with health-related physical fitness factors, depressive symptoms, and the number of chronic diseases in the middle-aged and elderly.Methods: We enrolled a total of 283 middle-aged and elderly participants from a rehabilitation clinic or health examination department. The PSQI was used to evaluate sleep quality. The health-related fitness assessment included anthropometric and physical fitness parameters. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D) short form. Data were analyzed with SPSS 18.0, and descriptive statistics and logistic regression analysis were used for the analyses.Results: Overall, 27.9% of participants in this study demonstrated poor sleep quality (with a PSQI score of >5), 10.2% of study participants frequently used sleep medication to help them fall asleep, and 6.0% reported having significant depressive symptoms (with a CES-D score of ≥10). There are two major findings: (1) depression symptoms, the number of chronic diseases, self-rated health, and arthritis were significantly associated with a poor sleep quality, and (2) the 2-min step test was associated with longer sleep latency. These results confirmed that the 2-min step was associated with a longer sleep latency among the health-related physical fitness items.Conclusions: Our study found that depressive syndrome, chronic disease numbers, a poor self-rated health status, and arthritis were the main risk factors that influenced subjective sleep quality.

scholarly journals Subjective sleep quality and association with depression syndrome, chronic diseases and health-related physical fitness in the middle-aged and elderly

2020 ◽  
Author(s):  
Min-Fang Hsu ◽  
Kang-Yun Lee ◽  
Tsung-Ching Lin ◽  
Wen-Te Liu ◽  
Shu-Chuan Ho
Keyword(s):  
Depressive Symptoms ◽  
Physical Fitness ◽  
Sleep Quality ◽  
Chronic Diseases ◽  
Poor Sleep ◽  
Middle Aged ◽  
Poor Sleep Quality ◽  
Subjective Sleep Quality ◽  
Subjective Sleep ◽  
Health Related

Abstract Background: As a complex phenomenon, sleep quality is difficult to objectively define and measure, and multiple factors related to sleep quality, such as age, lifestyle, physical activity, and physical fitness, feature prominently in older adult populations. The aim of the present study was to evaluate subjective sleep quality using the Pittsburgh Sleep Quality Index (PSQI) and to associate sleep quality with health-related physical fitness factors, depressive symptoms, and the number of chronic diseases in the middle-aged and elderly.Methods: We enrolled a total of 283 middle-aged and elderly participants from a rehabilitation clinic or health examination department. The PSQI was used to evaluate sleep quality. The health-related fitness assessment included anthropometric and physical fitness parameters. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression Scale (CES-D) short form. Data were analyzed with SPSS 18.0, and descriptive statistics and logistic regression analysis were used for the analyses.Results: Overall, 27.9% of participants in this study demonstrated poor sleep quality (with a PSQI score of >5), 10.2% of study participants frequently used sleep medication to help them fall asleep, and 6.0% reported having significant depressive symptoms (with a CES-D score of ≥10). There are two major findings: (1) depression symptoms, the number of chronic diseases, self-rated health, and arthritis were significantly associated with a poor sleep quality, and (2) the 2-min step test was associated with longer sleep latency. These results confirmed that the 2-min step was associated with a longer sleep latency among the health-related physical fitness items.Conclusions: Our study found that depressive syndrome, chronic disease numbers, a poor self-rated health status, and arthritis were the main risk factors that influenced subjective sleep quality.

Sleep quality in caregivers of patients with Alzheimer's disease and Parkinson's disease and its relationship to quality of life

2012 ◽  
Vol 24 (11) ◽  
pp. 1827-1835 ◽  
Author(s):  
Chiara Cupidi ◽  
Sabrina Realmuto ◽  
Gianluca Lo Coco ◽  
Antonio Cinturino ◽  
Simona Talamanca ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Alzheimer’S Disease ◽  
Depressive Symptoms ◽  
Sleep Quality ◽  
Sleep Disturbances ◽  
Poor Sleep ◽  
Poor Sleep Quality ◽  
Subjective Sleep Quality ◽  
Subjective Sleep

ABSTRACTBackground: Knowledge about sleep complaints of caregivers of patients with Alzheimer's disease (AD) and Parkinson's disease (PD) is limited, and we lack information about the relationship between caregivers’ sleep problems and their quality of life (QoL).Methods: We evaluated subjective sleep quality and its relationship to QoL in a group of 80 caregivers of patients with AD (ADCG, n = 40) and PD (PDCG, n = 40), and in 150 controls. Information about night-time complaints was collected using the Pittsburgh Sleep Quality Index (PSQI). QoL was measured using the McGill QoL Questionnaire.Results: Eighteen ADCG (45%), 22 PDCG (55%), and 45 (30%) controls reported poor sleep quality. Mean global PSQI score of PDCG (6.25 ± 3.9) was not significantly different from that of ADCG (5.8 ± 3.5; p = 0.67). However, both PDCG and ADCG scored significantly higher than control group (4.3 ± 3.1; p < 0.01). ADCG frequently reported difficulties falling asleep (72.5%) and disturbed sleep (100%). PDCG reported reduced subjective sleep quality (80%) and increased sleep disturbances (100%). Poor sleep quality was associated with depressive symptoms and correlated with QoL in caregivers of both groups, particularly the psychological symptoms domain.Conclusions: Among caregivers of patients with AD and PD, poor sleep quality is frequent and significantly linked to QoL and depressive symptoms. Identifying the nature of sleep disturbances not only in patients but also in their caregivers is important as appropriate treatment may lead to a better management of the needs of families coping with these patients.

scholarly journals Actigraphy-Derived Sleep Efficiency Is Associated With Endothelial Function in Men and Women With Untreated Hypertension

2020 ◽  
Author(s):  
LaBarron K Hill ◽  
Jade Q Wu ◽  
Alan L Hinderliter ◽  
James A Blumenthal ◽  
Andrew Sherwood
Keyword(s):  
Blood Pressure ◽  
Risk Factor ◽  
Endothelial Function ◽  
Sleep Quality ◽  
Sleep Efficiency ◽  
Poor Sleep ◽  
Cvd Risk ◽  
Subjective Sleep Quality ◽  
Subjective Sleep ◽  
Untreated Hypertension

Abstract BACKGROUND Poor sleep quality is increasingly recognized as an important and potentially modifiable risk factor for cardiovascular disease (CVD). Impaired endothelial function may be 1 mechanism underlying the association between poor sleep and CVD risk. The present study examined the relationship between objective measures of sleep quality and endothelial function in a sample of untreated hypertensive adults. METHODS Participants were 127 men (N = 74) and women (N = 53), including 55 African Americans and 72 White Americans, aged 40–60 years (mean age, 45.3 ± 8.5 years), with untreated hypertension (systolic blood pressure 130–159 mm Hg and/or diastolic blood pressure 85–99 mm Hg). Noninvasive brachial artery flow-mediated dilation (FMD) was assessed by ultrasound. Sleep parameters, including sleep efficiency (SE), total sleep time (TST), and subjective sleep quality, were assessed over 7 consecutive days by wrist actigraphy. RESULTS Participants averaged 7.76 ± 1 hours in bed, with an average SE of 78 ± 9%, and TST of 6 ± 1 hours. Brachial FMD averaged 3.5 ± 3.1%. In multivariate analyses controlling for sex, race, body mass index, clinic blood pressure, income, smoking, alcohol use, and baseline arterial diameter, SE was positively associated with FMD (β = 0.28, P = 0.012). Subjective sleep quality (β = −0.04, P = 0.63) and TST (β = −0.11, P = 0.25) were unrelated to FMD. CONCLUSIONS Poor sleep as indicated by low SE was associated with impaired FMD. These findings for SE are consistent with previous observations of other measures implicating poor sleep as a CVD risk factor. Interventions that improve sleep may also help lower CVD risk.

scholarly journals 1019 Subjective Sleep Quality and Sleep Recommendations Received by Patients with Cancer and Depression

SLEEP ◽  
2020 ◽  
Vol 43 (Supplement_1) ◽  
pp. A387-A387
Author(s):  
S N Price ◽  
J I Trejo ◽  
L M Halaby ◽  
D Guzman ◽  
Y Liu ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Sleep Quality ◽  
Physical Health ◽  
Poor Sleep ◽  
Cancer Type ◽  
Poor Sleep Quality ◽  
Subjective Sleep Quality ◽  
Subjective Sleep ◽  
Patients With Cancer ◽  
Adult Cancer Survivors

Abstract Introduction Diagnoses of cancer and depression are independent predictors of poor sleep, but less is known about subjective sleep quality among patients with both of these potential risk factors or about recommendations made by physicians for improving sleep among this population. This study examines correlates of poor subjective sleep quality and sleep recommendations received by patients with cancer enrolled in the Collaborative Oncology Project to Enhance Depression Care (COPE-D), a collaborative care intervention to treat depression among patients with cancer. Methods Participants were 74 adult cancer survivors. Demographic and clinical characteristics, subjective sleep quality, and provider sleep recommendations were obtained by patient self-report prior to intervention. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI), general health status was measured using the PROMIS Global-10, and depressive symptoms were measured using the PHQ-9. Results 81% of patients reported significantly poor sleep quality (PSQI global scores &gt;8) and 75.3% reported poor sleep efficiency (&lt;85%). The strongest correlates of poor sleep quality were worse global mental (r=-.431, p&lt;.01) and physical health (r=-.40, p=&lt;.01). 63% reported pain interference with sleep at least once per week. Cancer type and stage, current cancer treatment, and depressive symptoms were not significantly associated with poor sleep quality (p’s&gt;.05). 12% of those reporting sleep disturbances since their cancer diagnosis had not discussed these problems with a medical provider. Among those who talked to their provider, 41.8% reported receiving sleep hygiene recommendations, 40.5% anti-depressants, 14.9% sedative-hypnotic medication (e.g. zolpidem, benzodiazepines), 10.8% cognitive behavioral therapy, 9.6% antihistamines, 6.8% melatonin, and 4.1% were recommended meditation or hypnosis. Conclusion Cancer patients seeking treatment for depression report very high rates of poor subjective sleep quality, which was most strongly associated with global mental and physical health. Improved screening and patient-provider communication about sleep may be especially beneficial for this at-risk population. Support Merck Foundation Alliance to Advance Patient-Centered Cancer Care

scholarly journals 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

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.

The Effect of Uncoupled Sleep and Dysfunctional Sleep Beliefs on Sleep Outcomes in Older Adults following Online Cognitive Behavioral Therapy for Insomnia: A Single-Group Non-randomized Trial (Preprint)

2021 ◽  
Author(s):  
Yvonne Kutzer ◽  
Lisa Whitehead ◽  
Eimear Quigley ◽  
Shih Ching Fu ◽  
Mandy Stanley
Keyword(s):  
Older Adults ◽  
Cognitive Behavioral Therapy ◽  
Sleep Quality ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Behavioral Therapy ◽  
Sleep Onset ◽  
Poor Sleep ◽  
Subjective Sleep Quality ◽  
Subjective Sleep

BACKGROUND The current Covid-19 pandemic has brought about a marked interest in sleep health, as well as an increased demand for telehealth services, such as online Cognitive Behavioral Therapy for insomnia (CBT-I). Older adults in particular report a high rate of sleep problems. Recent studies have suggested that dysfunctional sleep beliefs could contribute to the high rates of self-reported insomnia in this age group. In addition, older adults have an increased rate of uncoupled sleep, e.g. displaying an insomnia complaint in the absence of objectively measured poor sleep. It is essential to determine the prevalence of coupled and uncoupled sleep in older adults and to examine the efficacy of online CBT-I to improve sleep outcomes. OBJECTIVE This study aims to assess objective and subjective sleep quality and dysfunctional sleep beliefs in a sample of community-dwelling older adults aged 60-80 years with and without uncoupled sleep in Western Australia following digitally delivered CBT-I. METHODS Objective sleep was measured using wrist actigraphy, and subjective sleep quality via sleep diaries and the Pittsburgh Sleep Quality Index (PSQI). Dysfunctional sleep beliefs were assessed by the Dysfunctional Beliefs and Attitudes about Sleep scale (DBAS-16) prior to and following a four-week online CBT-I programme. Linear mixed model and generalised linear mixed model analyses were conducted to examine objective and subjective sleep onset latency, total sleep time, wake after sleep onset and number of awakenings as well as PSQI and DBAS16 scores, respectively. RESULTS 62 participants (55 females; 88.7%) completed the study. CBT-I effectively reduced dysfunctional sleep beliefs and PSQI scores across all sleep classifications, even in good sleepers without a sleep complaint. Objective and self-reported changes in sleep parameters were mainly demonstrated in complaining poor sleepers. Complaining good sleepers reported a decrease in the number of subjective sleep awakenings only. CONCLUSIONS Online CBT-I was effective in improving the sleep outcomes of individuals who had both subjective and objective poor sleep. However, as the online CBT-I reduced dysfunctional sleep beliefs in all sleep groups, further examination of dysfunctional sleep beliefs and whether they mediate the outcomes of digital CBT-I in older adults will need to be conducted. CLINICALTRIAL Australian New Zealand Clinical Trials Registry (ANZCTR), ACTRN 12619001509156; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=378451 INTERNATIONAL REGISTERED REPORT RR2-32705

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