Residual Effects of Restless Sleep over Depressive Symptoms on Chronic Medical Conditions: Race by Gender Differences
Residual Effects of Restless Sleep over Depressive Symptoms on Chronic Medical Conditions: Race by Gender Differences
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DOI：
10.1007/s40615-015-0202-z
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发表时间：
2017-02-01
影响因子：
3.9
通讯作者：
Leggett, Amanda
中科院分区：
文献类型：
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作者：
Assari, Shervin;Sonnega, Amanda;Leggett, Amanda
背景睡眠和抑郁症是一种共病问题，随着时间的推移，它们会导致慢性疾病（CMC）的发展。虽然睡眠，抑郁症和CMC之间的双向关联的种族和性别差异是已知的，非常有限的信息存在的异质性的睡眠问题的残余影响，抑郁症状对CMC跨种族的性别群体。目的使用生命历程的角度来看，本研究比较种族性别组的残余影响不安的睡眠抑郁症状对CMC.Methods我们使用的数据从波1（1986年），4（2001年），5（2011年）的美国人的生活改变研究（ACL）。这项研究对294名白色男性、108名黑人男性、490名白色女性和237名黑人女性进行了长达25年的跟踪调查。在1986年、2001年和2011年测量了不安睡眠、抑郁症状（流行病学中心抑郁量表[CES-D]）和慢性疾病（高血压、糖尿病、慢性肺病、心脏病、中风、癌症和关节炎）的数量。我们采用多组交叉滞后建模，慢性疾病的结果和种族的性别groups.Results主要组的差异被发现在不安的睡眠对CMC的剩余影响超过抑郁症状跨种族的性别组。2001年的不安睡眠预测了2011年黑人女性10年后的CMC（标准化调整B = .135，P < .05）和白色男性（标准化调整= 0.145，P <0.01）和白色女性（标准化调整后的B = 0.171，P <0.001）但黑人男性则不然（标准化调整后的B = .001，P > 0.05）结论25年以上不安睡眠对CMC的剩余效应存在种族性别异质性，提示共病差的抑郁症状患者，睡眠和抑郁症状在基于种族和性别交叉的亚群中不同地促进多发病的发展。因此，试图预防共病睡眠问题和抑郁症的干预措施作为预防医疗条件的策略可能会受益于基于种族和性别交叉的定制。
Background Sleep and depression are comorbid problems that contribute to the development of chronic medical conditions (CMC) over time. Although racial and gender differences in the bidirectional associations between sleep, depression, and CMC are known, very limited information exists on heterogeneity of the residual effects of sleep problems over depressive symptoms on CMC across race by gender groups. Aim Using a life-course perspective, the present study compared race by gender groups for residual effects of restless sleep over depressive symptoms on CMC.Methods We used data from waves 1 (year 1986), 4 (year 2001), and 5 (year 2011) of the Americans' Changing Lives Study (ACL). The study followed 294 White men, 108 Black men, 490 White women, and 237 Black women for 25 years. Restless sleep, depressive symptoms (Center for Epidemiological Studies-Depression scale [CES-D]), and number of chronic medical conditions (hypertension, diabetes, chronic lung disease, heart disease, stroke, cancer, and arthritis) were measured in 1986, 2001, and 2011. We employed multi-group cross-lagged modeling, with chronic medical conditions as the outcome and race by gender as the groups.Results Major group differences were found in the residual effect of restless sleep on CMC over depressive symptoms across race by gender groups. Restless sleep in 2001 predicted CMC 10 years later in 2011 among Black women (standardized adjusted B = .135, P < .05) and White men (standardized adjusted = .145, P < .01) and White women (standardized adjusted B = .171, P < .001) but not Black men (standardized adjusted B = .001, P > .05).Conclusion Race by gender heterogeneity in the residual effect of restless sleep over depressive symptoms on CMC over 25 years suggests that comorbid poor sleep and depressive symptoms differently contribute to development of multimorbidity among subpopulations based on the intersection of race and gender. Thus, interventions that try to prevent comorbid sleep problems and depression as a strategy to prevent medical conditions may benefit from tailoring based on the intersection of race and gender.