de Menezes-Júnior Luiz Antônio Alves, de Moura Samara Silva, Machado-Coelho George Luiz Lins, Meireles Adriana Lúcia
Postgraduate Program in Health and Nutrition, School of Nutrition, Federal University of Ouro Preto, R. Diogo de Vasconcelos, 122, Ouro Preto, Minas Gerais, Brazil.
Research and Study Group on Nutrition and Public Health (GPENSC), Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil.
Sci Rep. 2025 Apr 15;15(1):12952. doi: 10.1038/s41598-025-98004-0.
During crisis periods, understanding the impact of sleep quality on self-rated health becomes crucial. However, the role of anxiety and depression as potential mediators in this relationship remains insufficiently explored. Therefore, this study aimed to assess the association of sleep quality with self-rated health, and mediation by anxiety and depression. This cross-sectional, population-based study was conducted with 1762 adults from October to December 2020 in the Iron Quadrilateral region of Brazil. The exposure variable was poor sleep quality, as measured by the PSQI. The outcome was self-rated health. The mediators tested were anxiety and depression, which were evaluated using symptoms, medical diagnoses, and the use of drugs. To test the mediators' factors, the Karlson-Holm-Breen method was used. The direct acyclic graph was used to select a minimal set of adjustments in multivariate analysis. There were 22.6% of people who rated their health as poor, 52.5% were poor sleepers, 35.1% had symptoms of anxiety and 24.7% had symptoms of depression. According to the multivariate analysis, individuals with poor sleep quality were 2.82 times more likely to self-assess their health as poor. The presence of symptoms of anxiety and depression explained 16.57% and 5.99% of the association between poor sleep quality and poor self-rated health, respectively, in the mediation analysis. During the COVID-19 pandemic, individuals who had poor sleep quality had lower self-rated health. Furthermore, symptoms of anxiety and depression explained a portion of the association. Our study emphasizes the importance of evaluating individuals' sleep quality and mental health during a crisis.
在危机时期，了解睡眠质量对自我健康评价的影响变得至关重要。然而，焦虑和抑郁作为这种关系中潜在中介因素的作用仍未得到充分探索。因此，本研究旨在评估睡眠质量与自我健康评价之间的关联，以及焦虑和抑郁的中介作用。这项基于人群的横断面研究于2020年10月至12月对巴西铁四角地区的1762名成年人进行。暴露变量是通过匹兹堡睡眠质量指数（PSQI）测量的睡眠质量差。结果是自我健康评价。所测试的中介因素是焦虑和抑郁，通过症状、医学诊断和药物使用情况进行评估。为了测试中介因素，使用了卡尔森 - 霍尔姆 - 布林方法。在多变量分析中，使用直接无环图来选择一组最小的调整变量。有22.6%的人将自己的健康评为差，52.5%的人睡眠质量差，35.1%的人有焦虑症状，24.7%的人有抑郁症状。根据多变量分析，睡眠质量差的个体自我评估健康差的可能性高出2.82倍。在中介分析中，焦虑症状和抑郁症状分别解释了睡眠质量差与自我健康评价差之间关联的16.57%和5.99%。在新冠疫情期间，睡眠质量差的个体自我健康评价较低。此外，焦虑和抑郁症状解释了部分这种关联。我们的研究强调了在危机期间评估个体睡眠质量和心理健康的重要性。
