Department of Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY, USA.
Department of Social Welfare, Luskin School of Public Affairs, University of California, Los Angeles, CA, USA.
Depress Anxiety. 2018 Jun;35(6):583-591. doi: 10.1002/da.22764. Epub 2018 Apr 26.
Anxiety and depression are commonly comorbid with each other, with anxiety often temporally preceding the development of depression. Although increasingly research has begun to investigate the role of sleep problems in depression, no study has examined insomnia as a mediator in the longitudinal relationship between anxiety and subsequent depression.
The current study utilizes data from Waves I, II, and IV of the National Longitudinal Study of Adolescent to Adult Health, a nationally representative prospective study conducted over a 14-year period (n = 20,745, 50.5% female, M age at Wave I = 16.20). Participants completed portions of the Center for Epidemiologic Studies Depression Scale at Waves I and IV to assess depressive symptoms, a six-item anxiety measure at Wave I, and three items assessing insomnia, sleep quality, and sleep duration at Wave II.
Structural equation modeling indicated that insomnia and unrestful sleep significantly mediated the relationship between anxiety and subsequent depression. The relationship between anxiety and depression was not significantly mediated by sleep duration.
Findings suggest that anxiety may increase risk for the development of later depression through insomnia.
焦虑和抑郁通常是共病的，焦虑往往先于抑郁的发生。尽管越来越多的研究开始探讨睡眠问题在抑郁中的作用，但没有研究调查失眠作为焦虑与随后抑郁之间纵向关系的中介因素。
本研究利用了全国青少年至成人健康纵向研究的第 I、II 和 IV 波的数据，这是一项为期 14 年的全国代表性前瞻性研究（n=20745，女性占 50.5%，第 I 波时的平均年龄为 16.20 岁）。参与者在第 I 和 IV 波完成了中心流行病学研究抑郁量表的部分内容，以评估抑郁症状，在第 I 波完成了一个六项焦虑测量，以及在第 II 波完成了三个评估失眠、睡眠质量和睡眠时间的项目。
结构方程模型表明，失眠和不安的睡眠显著中介了焦虑与随后抑郁之间的关系。焦虑和抑郁之间的关系并没有被睡眠时间显著中介。
研究结果表明，焦虑可能通过失眠增加了随后发生抑郁的风险。
