The Association of Sleep Duration and Depressive Symptoms in Rural Communities of Missouri, Tennessee, and Arkansas

Abstract

Purpose To determine the association between sleep duration and depressive symptoms in a rural setting. Methods We conducted a cross-sectional study using data from Wave 3 of the Walk the Ozarks to Wellness Project including 12 rural communities in Missouri, Arkansas, and Tennessee (N = 1,204). Sleep duration was defined based on average weeknight and weekend hours per day: short (< 7), optimal (7-8), and long (> 8). The primary outcome was self-reported elevated depressive symptoms. Multivariable logistic regression was used to estimate adjusted prevalence odds ratios (aPOR) and 95% confidence intervals (95% CI). Findings Elevated depressive symptoms were common in this rural population (17%). Depressive symptoms were more prevalent among subjects with short (26.1%) and long (24%) sleep duration compared to those with optimal (11.8%) sleep duration. After adjusting for age, gender, race, education, employment status, income, and BMI, short sleep duration was associated with increased odds of elevated depressive symptoms (aPOR=2.12, 95% CI: 1.49, 3.01), compared to optimal sleep duration. Conversely, the association between long sleep duration and depressive symptoms was not statistically significant after covariate adjustment. Similar findings were observed when we excluded individuals with insomnia symptoms for analysis. Conclusions This study suggests that short sleep duration (<7 hours per night) and depressive symptoms are common among rural populations. Short sleep duration is positively associated with elevated depressive symptoms. The economic and healthcare burden of depression may be more overwhelming among rural populations, necessitating the need to target modifiable behaviors such as sleep habits to improve mental health.

Prevalence and correlates of psychological distress among diabetes mellitus adults in the Jilin province in China: a cross-sectional study

“…Poor sleep is an important etiology of depression (Chang et al, 2012; Paunio et al, 2014). This observation is in agreement with our finding that participants with short sleep durations had higher likelihood of developing psychological distress.…”

Joint Consensus Statement of the American Academy of Sleep Medicine and Sleep Research Society on the Recommended Amount of Sleep for a Healthy Adult: Methodology and Discussion

“…77,79,80,85 Short self-reported sleep duration is associated with increased cross-sectional and longitudinal risk for depression, whether measured as symptoms or as a diagnosis. 77,[79][80][81][82][83][84]86 The threshold for short sleep varies across studies from 5-7 hours, with the majority using 6 hours. Some data also demonstrate increased risk associated with sleep duration longer than 8-9 hours.…”

Cultural beliefs affecting sleep duration

“…The studies in this area focus on the change in sleep duration between race, ethnic groups and regional differences . It can also be said that sleep duration is a feature that may vary due to population structure and urban/rural environment . Hale and Doindicated in their study that blacks and some other racial minorities as Hispanics (excluding Mexican Americans) and non‐Hispanic “Others” were related to increased risk of short sleeping.…”

“…Sleep duration change in urban environments depends on stressors, neighborhood, living environment and structural conditions. It has been reported that in rural areas, the average sleep time is less than 7 h and short sleep duration increases the risks of depression and obesity …”