Prospective relationships of mentally passive sedentary behaviors with depression: Mediation by sleep problems

Abstract

Background: As distinct from mentally-active sedentary behaviors (e.g. reading), passive sedentary behaviors (e.g. TV-viewing) have been linked to a higher risk of depression, but the underlying mechanisms are unclear. We examined the potential mediating role of sleep problems in prospective relationships of passive sedentary behaviors with major depressive disorder (MDD). Method: In 1997, 43 863 adults were surveyed and responses linked to clinician diagnoses of MDD until 2010. The questionnaire included items on sedentary behavior and sleep problems (Karolinska Sleep Questionnaire). Cox proportional hazard models and the 'counterfactual approach' were used to identify potential mediating effects of sleep problems in the association of passive sedentary behavior and MDD. Results: Of the total sample, 3,065 (7.6%) were excluded for having indications of depression at baseline. Of 33,116 participants with complete data (mean age = 51.3 years, SD = 15.7, 64% female); 472 (1.4%) incident cases of MDD were identified during the 13-year follow-up. In Cox regression analyses, higher durations of passive sedentary behavior (≥3 h/day versus <3 h/day) were associated with greater hazards of developing MDD (HR = 1.27; 95% CI = 1.01, 1.58). This relationship remained after adjusting for confounders (HR = 1.29; 95% CI = 1.03, 1.63). Adding sleep problems into the analysis significantly attenuated these relationships (HR = 1.25; 95% CI = 0.99, 1.57). The excess MDD relative risk of passive sedentary behaviors due to sleep problems was statistically significant. Limitations: Measures of sedentary behavior, physical activity and sleep were self-reported. Conclusion: Sleep problems appear to mediate detrimental associations of passive sedentary behavior with depression. Findings require further confirmation using objective measures. 2016; Zhai et al., 2014); those with MDD have 50% higher odds of being inactive compared to those without depression (Schuch et al., 2018), and structured exercise is shown to reduce depressive symptoms in psychiatric populations (Barbour et al., 2007; Schuch et al., 2016). Physical activityeven in small 'doses'-is also protective against depression onset (

The mediation role of sleep quality in the association between the incidence of unhealthy movement behaviors during the COVID-19 quarantine and mental health

“…Considering the times before the COVID-19 pandemic, movement behaviors were associated with mental health [ 8 ] as well as sleep quality [ 10 , 12 ] and sleep quality was prospectively associated with mental health [ 26 ]. In this sense, sleep quality could act as a mediator of the association between movement behaviors and mental health [ [16] , [17] , [18] ]. Therefore, our findings agree with previous studies from before quarantine [ [16] , [17] , [18] ].…”

“…In this sense, sleep quality could act as a mediator of the association between movement behaviors and mental health [ [16] , [17] , [18] ]. Therefore, our findings agree with previous studies from before quarantine [ [16] , [17] , [18] ]. However, these results suggest that the association between the incidence of unhealthy movement behaviors and mental health can be mediated by worsening sleep quality even in relatively short periods of movement deprivation and quarantine.…”

“…In this sense, cross-sectional and prospective studies found that sleep quality can mediate the association between movement behaviors (especially sedentary behavior) and mental health indicators [ [16] , [17] , [18] ]. Therefore, the reductions in physical activity practice and increased sedentary behavior during COVID-19 quarantine can affect sleep quality, which, in turn, can be associated with poorer mental health.…”

Sitting Time, Type, and Context Among Long‐Term Weight‐Loss Maintainers

“…Weight-loss maintainers and controls also did not appreciably differ in time spent sitting while reading or studying, traveling, or talking/texting/socializing. These could be considered more mentally active forms of sedentary behavior (29,30). Interestingly, prior research has suggested that substituting passive with mentally active sedentary behaviors or physical activity may have beneficial health effects (29)(30)(31).…”

“…These could be considered more mentally active forms of sedentary behavior (29,30). Interestingly, prior research has suggested that substituting passive with mentally active sedentary behaviors or physical activity may have beneficial health effects (29)(30)(31). Current behavioral weight-loss interventions tend to target a reduction in time spent watching TV.…”