The role of depression and physical activity in the association of between sleep quality, and duration with and health-related quality of life among the elderly: a UK Biobank cross-sectional study

Abstract

Background Although studies have shown that sleep quality (duration) is associated with health-related quality of life (HRQoL), most of these studies have been small-sized and targeted at young and middle-aged adults. In addition, few studies have explored the path mechanism of sleep disorders leading to impaired HRQoL. Objectives This study aimed to determine the association between sleep quality and duration and HRQoL among the elderly in the United Kingdom, assess whether depression mediated the association, and explore the role of physical activity (PA) in the path association. Methods Data were extracted from the baseline survey of the UK Biobank, a large prospective cohort study enrolling more than 500,000 participants, of which 52,551 older adults (aged ≥60 years) were included in the study. HRQoL was assessed using the European Quality of Life-5 Dimensions. Tobit and multivariate logistic regression models were used to determine the association between sleep quality and duration and HRQoL. The mediating and moderated mediation models were estimated using the PROCESS macro and MEDCURVE macro. Results The Tobit model showed that the elderly with short or long sleep duration (β = − 0.062, 95% confidence interval [CI] = − 0.071 to − 0.053; β = − 0.072, 95% CI = − 0.086 to − 0.058) had worse HRQoL after adjusting potential covariates. In the logistic regression models, we found an inverted U-shaped association between sleep duration and HRQoL. Moreover, a significant positive association was observed between sleep quality and HRQoL (all P < 0.05). The results also revealed that depression mediated the association between sleep disorders and HRQoL (sleep quality: β = 0.008, 95% CI = 0.007–0.010; sleep duration: θ = 0.001 [mean], 95% CI = 0.001–0.002). Furthermore, PA moderated all paths among sleep quality and duration, depression, and HRQoL, and greater effects were observed in the elderly with lower PA levels. Conclusions The findings show that poor sleep quality and duration were independently associated with worse HRQoL among the elderly in the United Kingdom. Furthermore, PA buffers the mediating effect of depression and adverse effects of sleep disorders on HRQoL. It is essential to properly increase PA and provide early intervention for depression in the elderly with sleep disorders to improve their HRQoL.

The Effect of Depressive and Insomnia Symptoms in Quality of Life among Community-Dwelling Older Adults

“…These findings are consistent with previous studies examining the effect that depression, insomnia, and comorbid depression and insomnia can have on the QoL of older adults [ 14 , 15 ]. For example, a recent study that sought to evaluate the relationship between sleep quality, duration, and health-related QoL among older adults in the United Kingdom discovered that poor sleep quality and duration were independently linked with worse health-related QoL in the studied population [ 29 ]. This could be explained by the fact that poor sleep depletes energy during the day and has a detrimental impact on daily function.…”

Constipation preceding depression: a population-based cohort study

“…The following baseline variables were used as the covariates in this study: (1) sociodemographic characteristics, including age, sex, socioeconomic status, ethnicity, education level, and living status; (2) lifestyle factors, including body mass index (BMI), current smoking status, alcohol consumption, physical activities, sleep quality, and healthy diet 23 , 24 , 25 ; (3) health conditions, including the chronic diseases, chronic pain, and family history of depression; (4) regular medication use, including opioids, anticholinergic drugs, statins, steroids, calcium channel blockers, and antidiarrheal agents. Socioeconomic status was measured by the Townsend deprivation index, which refers to the material deprivation of the local community an individual belongs to, in reference to the wider society.…”

Associations Between Workplace Violence and Mental Health Among Chinese Health Technicians: A Moderated Mediation Analysis of Sleep Quality and Physical Activity

“…Physical activity played a moderated role between sleep quality and health related quality of life among the elderly. 36 In a study by Swedish municipal workers, physical activity was found to play a marginal moderating role in the relationship between work stress, self-rated health, and sleep quality. 37 Among the officers who were insufficient active or inactive, sleep quality was associated with cortisol awakening response, but among officers who were active, sleep quality was not associated with cortisol awakening response, suggesting that physical activity could expose a potential protective effect.…”

“…59 The underlying psychological mechanism might be that thermoregulation was the basis of sleep, physical activity had the effect of producing heat, raising body temperature, and then activating the hypothalamic controlled cooling process and sleep induction mechanism, energy consumption could also increase sleep. 36,61 Health technicians who had experienced WPV can improve sleep efficacy and length of sleep, if they practiced physical activity regularly, which in turn improved sleep quality.…”

“…Sleep disturbances might reduce maximum oxygen consumption, increase the change of exercise-related injuries, and lead to daytime fatigue, which reduced the frequency and events of exercise, increased the chance of adverse health outcomes. 36 And another explanation was that health technicians often on night shifts, it led to poor sleep quality, lacked of energy during the day, and difficulty in regular physical activity. Research proposed 45-60 minutes of moderate to vigorous exercise 3-5 days a week was good for adolescent physical and mental health.…”