MEDIATION EFFECT OF DEPRESSION ON THE RELATIONSHIP BETWEEN SLEEP DISTURBANCE AND QUALITY OF LIFE
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Authors: Sami Y. Al-Rawashdeh, Debra K. Moser, Terry A. Lennie, Misook L. Chung
Keywords: depression, sleep disturbance, quality of life, family caregivers, mediation effect
Abstract: Sleep disturbances, depression, and poor quality of life (QoL) are commonly reported by family caregivers of patients with heart failure. QoL has been known to be predicted by depression and sleep disturbance in many populations. Sleep disturbances and depression have a very close relationship and there is high possibility that depressive symptoms levels may mediate the relationship between sleep disturbance and QoL. The aim of this secondary analysis study of baseline data of a longitudinal study was to examine whether depressive symptoms mediate the relationship between sleep disturbance and QoL in 116 family caregivers of patients with heart failure. Most of the caregivers were female married, and Caucasians with mean age 56±14 years. Sleep disturbance score was measured using a composite score of 4 items related to common complaints related to sleep. The Six-Item Brief Symptom Inventory depressive symptoms subscale was used to measure depression with high scores indicating high levels of depressive symptoms. QoL was measured using the Short-Form 12 Health Survey (SF-12) which is composed of physical and the mental well-being components. Four multiple regression analyses were used to determine the significance of the mediation effect for each outcome variable (physical and the mental well-being components). Results indicated that sleep disturbance relationship to the mental well-being was shown to be a partially mediated by depressive symptoms (36.6% of the total effect was indirect through depressive symptoms). The physical well-being was mainly direct but not through depressive symptoms (mediation not significant). Health care providers should regularly assess family caregivers for sleep disturbance and depressive symptoms and improve QoL in particular the mental well-being through managing both sleep disturbance as well as depressive symptoms.