The effect of sleep disturbance on the association between chronic medical conditions and depressive symptoms over time

Abstract

Chronic medical conditions (CMC) and sleep disturbances are common among adults and associated with depression. We tested sleep disturbance as a moderator of the effect of CMC on depressive symptoms. The sample includes 3597 adults surveyed up to five times over 25 years (1986–2012) from the nationally representative American’s Changing Lives Study (ACL). A multi-level model was estimated to examine sleep disturbance as a moderator of the CMC and depressive symptom association, with a second interaction tested for age as a moderator of the within-person level variability in CMC and depressive symptom association. Sleep disturbance and CMC were associated with depressive symptoms at the between-person level, while only sleep disturbance was associated with depressive symptoms at the within-person level. Sleep disturbance significantly interacted with CMC such that more CMCs were associated with more depressive symptoms among individuals sleeping well, but poor sleep was associated with worse depression regardless of CMC. A second interaction between age and within-person variability in CMC was found significant, suggesting that younger adults had higher symptoms of depression at times of below average CMC relative to older adults. The effect of CMC on depressive symptoms may depend on sleep as well as age. Sleeping restfully may allow individuals with CMC the rejuvenation needed to cope with illness adaptively.

Insomnia Symptoms among African-American Older Adults in Economically Disadvantaged Areas of South Los Angeles

“…Our results are specific to an urban sample of African–American older adults who live in an economically challenged area. The results should be cautiously compared with the literature on other demographic groups, across locations, racial and ethnic groups, and SES levels [15,16,70,71]. Our findings may not be relevant to Whites, younger African–American adults, and even African–American older adults with higher SES.…”

Suicide Attempts in Michigan HealthCare System; Racial Differences

“…However, higher education may not be as protective for Blacks as it is for Whites [ 21 ]. Another major difference is chronic medical conditions, which were more closely associated with depression among Blacks at each time point [ 52 ]; however, physical health and depression may be better linked over time for Whites than Blacks [ 53 , 54 , 55 , 56 ]. Many of these racial differences have implications for mental health screening and suicide prevention of individuals based on race.…”

Factors Associated With Poor Sleep in Older Women Diagnosed With Breast Cancer

“…Depression: Depression can affect sleep by causing issues like insomnia and hypersomnia (Geoffroy et al, 2018). For people diagnosed with chronic medical conditions, depression can interfere with sleep, reducing the ability of the body to engage in restorative rest necessary for healing (Leggett, Assari, Burgard, & Zivin, 2017). Lack of sleep can affect depression (Maglione et al, 2014), and depression is associated with sleep disorders.…”

“…Lack of sleep can affect depression (Maglione et al, 2014), and depression is associated with sleep disorders. For many people suffering with depression, impaired sleep causes less restorative rest, therefore enhancing symptom burden (Leggett et al, 2017).…”