Bowman, Marissa
(2019)
Depressive symptoms and sleep health in midlife women: The Study of Women's Health Across the Nation (SWAN).
Master's Thesis, University of Pittsburgh.
(Unpublished)
This is the latest version of this item.
Abstract
Background: Depressive symptoms and sleep disturbances disproportionately affect midlife women, with long-term health consequences to women’s health. Previous studies have reported that depressive symptoms are associated with individual components of sleep, but this approach does not consider the 24-hour integration of nocturnal sleep, circadian timing, and daytime functioning. Additionally, the mechanisms underlying the association have not been elucidated. The current study examines the longitudinal association between depressive symptoms and a multidimensional construct, sleep health, as well as evaluates body mass index and physical activity as possible pathways explaining this relationship.
Methods: Depressive symptoms were assessed at 6-9 annual assessments in 302 midlife women (52.1±2.1y) from the Study of Women’s Health Across the Nation. Six months later, wrist actigraphy (M = 25.8 days) and validated questionnaires were collected, which were used to assess components of sleep health: efficiency, duration, timing (wake time minus sleep onset, divided by two), regularity (standard deviation of timing), alertness, and satisfaction. Each component was dichotomized based on evidence-based cut-off scores, and the six components were summed; higher values indicated better sleep health. Associations between depressive symptoms and sleep health were evaluated using linear regression for composite sleep health and logistic regression for each component of sleep health, adjusting for age, race, study site, menopausal status, vasomotor symptoms, apnea-hypopnea index, and use of medications that affect sleep. Parallel multiple mediation was used to test whether body mass index (BMI) and physical activity mediated the association between depressive symptoms and sleep health.
Results: Higher mean depressive symptoms was associated with poorer sleep health in unadjusted (beta = -0.30, p < .001) and adjusted models (beta = -0.24, p < .001). Greater variability in depressive symptoms was associated with poorer sleep health in unadjusted (beta = -0.14, p = .02), but not adjusted models (p = .16). Physical activity and BMI explained a significant portion of the variance in the association between mean depressive symptoms and sleep health.
Conclusion: Mean depressive symptoms are longitudinally associated with sleep health. Depressive symptoms are related to sleep health, in part, through BMI and physical activity, suggesting a possible point of intervention.
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Details
| Item Type: |
University of Pittsburgh ETD
|
| Status: |
Unpublished |
| Creators/Authors: |
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| ETD Committee: |
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| Date: |
30 January 2019 |
| Date Type: |
Publication |
| Defense Date: |
8 November 2018 |
| Approval Date: |
30 January 2019 |
| Submission Date: |
3 December 2018 |
| Access Restriction: |
No restriction; Release the ETD for access worldwide immediately. |
| Number of Pages: |
83 |
| Institution: |
University of Pittsburgh |
| Schools and Programs: |
Dietrich School of Arts and Sciences > Psychology |
| Degree: |
MS - Master of Science |
| Thesis Type: |
Master's Thesis |
| Refereed: |
Yes |
| Uncontrolled Keywords: |
sleep; depression; body mass index; physical activity; menopause |
| Date Deposited: |
30 Jan 2019 16:37 |
| Last Modified: |
30 Jan 2019 16:37 |
| URI: |
http://d-scholarship.pitt.edu/id/eprint/35691 |
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Depressive symptoms and sleep health in midlife women: The Study of Women's Health Across the Nation (SWAN). (deposited 30 Jan 2019 16:37)
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