Open AccessAssociation between socioeconomic status and longitudinal sleep quality patterns mediated by depressive symptoms
Author(s) -
Ga Bin Lee,
Hyeon Chang Kim,
Ye Jin Jeon,
Sun Jae Jung
Publication year - 2021
Publication title -
sleep
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.222
H-Index - 207
eISSN - 1550-9109
pISSN - 0161-8105
DOI - 10.1093/sleep/zsab044
Subject(s) - pittsburgh sleep quality index , socioeconomic status , mediation , longitudinal study , depression (economics) , beck depression inventory , demography , household income , logistic regression , psychology , medicine , educational attainment , gerontology , psychiatry , sleep quality , insomnia , anxiety , population , environmental health , history , macroeconomics , archaeology , pathology , sociology , political science , law , economics , economic growth
Study Objectives We aimed to examine whether associations between socioeconomic status (SES) and longitudinal sleep quality patterns are mediated by depressive symptoms. Methods We utilized data on 3347 participants in the Korean Genome and Epidemiology Study aged 40–69 years at baseline from 2001 to 2002 who were followed up for 16 years. A group-based modeling approach was used to identify sleep quality trajectories using the Pittsburgh Sleep Quality Index (years 2, 6, 8, 10, and 12). Educational attainment (college graduated or less), monthly household income (≥$2500 or less), and occupation (unemployed, manual labor, and professional labor) at baseline (year 0) were used for analyses. Depressive symptoms were assessed using Beck’s Depression Inventory at year 4. Associations between SES and sleep quality patterns were examined using a multinomial logistic regression model. The mediation effect of depressive symptoms was further examined using PROC CAUSALMED. Results We identified five distinct sleep quality trajectories: “normal-stable” ( n = 1697), “moderate-stable” ( n = 1157), “poor-stable” ( n = 320), “developing to poor” ( n = 84), and “severely poor-stable” ( n = 89). Overall, associations between SES levels and longitudinal sleep patterns were not apparent after full adjustment for sociodemographic and lifestyle factors measured at baseline. Depressive symptoms, however, tended to fully mediate associations between SES levels and sleep quality patterns (odds ratio range for indirect effects of depressive symptoms: for education, 1.05-1.17; for income, 1.05-1.15). Conclusion A significant mediating role for depressive symptoms between SES levels and longitudinal sleep quality warrants consideration among mental healthcare professionals.