Chery Maurice Junior, Baral Amrit, Rolle LaShae D, Abdshah Alireza, Bernard Maritza J, Poudel Laxmi, Francois Laura, Jones Deborah L, Jean-Louis Girardin, Blanc Judite
Department of Public Health Sciences, the University of Miami Miller School of Medicine, Miami, Florida, USA.
Anne Bates Leach Eye Hospital at Bascom Palmer Eye Institute, the University of Miami Miller School of Medicine, Miami, FL, USA.
Nat Sci Sleep. 2024 Jan 13;16:17-31. doi: 10.2147/NSS.S434148. eCollection 2024.
The COVID-19 pandemic has had a profound impact on mental health worldwide, with depression and sleep problems among the most common issues experienced by many individuals. Depression can lead to sleep problems, which can increase the risk of developing depressive symptoms. However, it is unclear which United States (US) sub-population was most affected by depression and sleep problems during the pandemic.
We conducted a secondary analysis using self-reported data from the 2021 National Health Interview Survey (NHIS), focusing on adults aged 18 years and above (n=29,763). We utilized self-reported responses to questions about prescription medication and frequency of depressive feelings to determine participants' depression status. Appropriate weights were applied to account for the sampling design of the surveys. Our analysis involved descriptive statistics and chi-squared tests to compare sociodemographic, clinical, behavioral, and sleep-related characteristics between US adults with and without depression. Additionally, logistic regression was used to examine the associations between sleep duration, sleep quality and depression.
The overall prevalence of depression in our sample was 44.4%. It were higher in certain demographic groups, including younger adults (18-39 years, 47.7%), non-Hispanic whites (47.9%), females (50.1%), those at the lower income bracket (52.2%), those with no college or degree (48.7%) uninsured individuals (45.2%), and those reporting poor general health (71.9%). Individuals with depression had a 12% increased odds of experiencing short sleep (aOR: 1.12, 95% CI:1.04-1.20, p<0.001), 34% increased odds of experiencing long sleep (aOR: 1.34, 95% CI: 1.20-1.50, p < 0.001) and more than 2.5 fold increased odds of reporting poor sleep quality (aOR:2.57, 95% CI: 2.40-2.78; p<0.0001). In the multivariate analysis, all variables (sex, race/ethnicity, education, health insurance coverage, marital status, general health status and use of sleep medications, smoking and alcohol use status) were significantly predictors of poor sleep quality, with the exceptions of age and family income.
The findings emphasize the need to address sleep health in treating depression, especially during times of public health crises.
新冠疫情对全球心理健康产生了深远影响，抑郁和睡眠问题是许多人最常出现的问题。抑郁会导致睡眠问题，而睡眠问题又会增加出现抑郁症状的风险。然而，尚不清楚疫情期间美国哪些亚人群受抑郁和睡眠问题影响最大。
我们使用2021年国家健康访谈调查（NHIS）的自我报告数据进行了二次分析，重点关注18岁及以上的成年人（n = 29,763）。我们利用对有关处方药和抑郁情绪频率问题的自我报告回答来确定参与者的抑郁状况。应用了适当的权重以考虑调查的抽样设计。我们的分析包括描述性统计和卡方检验，以比较有抑郁和无抑郁的美国成年人在社会人口统计学、临床、行为和睡眠相关特征方面的差异。此外，使用逻辑回归来检验睡眠时间、睡眠质量与抑郁之间的关联。
我们样本中抑郁的总体患病率为44.4%。在某些人口群体中患病率更高，包括年轻人（18 - 39岁，47.7%）、非西班牙裔白人（47.9%）、女性（50.1%）、低收入人群（52.2%）、没有大学学历的人（48.7%）、未参保者（45.2%）以及报告总体健康状况较差的人（71.9%）。患有抑郁症的人出现短睡眠（调整后比值比：1.12，95%置信区间：1.04 - 1.20，p < 0.001）的几率增加12%，出现长睡眠（调整后比值比：1.34，95%置信区间：1.20 - 1.50，p < 0.001）的几率增加34%，报告睡眠质量差（调整后比值比：2.57，95%置信区间：2.40 - 2.78；p < 0.0001）的几率增加超过2.5倍。在多变量分析中，除年龄和家庭收入外，所有变量（性别、种族/族裔、教育程度、医疗保险覆盖范围、婚姻状况、总体健康状况以及使用睡眠药物、吸烟和饮酒状况）都是睡眠质量差的显著预测因素。
研究结果强调在治疗抑郁症时，尤其是在公共卫生危机期间，需要关注睡眠健康。
