Abstract

Both sleep disturbances and depressive mood are closely associated with wide-range daytime dysfunctions. Yet limited study closely investigates daytime functioning variables after treatments for sleep disturbances either coexisting with or without depressive mood Participants Participants were 185 individual with co-existing sleep and mood disturbances (92 in I-BMS; 93 in WLC). Daytime functioning variables were measured by items from Pittsburg Sleep Quality Index (PSQI-day) indicating daytime dysfunctions, Somatic subscale from Somatic Symptom Inventory (SSI), Anxiety subscale from Hospital Anxiety Depression Scale (HADS) and 12-Item Short Form Health Survey (SF-12) represented by Mental and Physical Component scores (MCS and PCS). Data were collected at baseline, post-treatment (8 weeks) and three-month follow-up. Multiple imputations were firstly conducted to evaluate effect size of each daytime variables after treatments. Then, regression analyses were used to reveal associations between daytime variables at follow-up and previous changes in nighttime sleep qualities (PSQI-Night) and mood (Center for Epidemiological Studies Depression after minus sleep item- CESD-M) at post-treatment respectively. At last, path analyses were used to understand interplays among daytime functioning, sleep and mood. We found that there was a small to large between-group effect size (0.20–0.70) on daytime functioning and a medium to large within-group effect size (0.53–0.89) in the I-BMS group. After adjusting for group and baseline scores, CESD-M was the most important predictor of daytime functioning. PSQI-day was associated with both PSQI-nightand CESD-M. Path analyses indicated that PSQI-day bridged PSQI-night and CESD-M in a 2-way direction (Χ2=12.36, p=0.34, df=11, Χ2/df=1.1; RMSEA=0.026; CFI=0.989; TLI=0.980; Χ2=12.10, p=0.36, df=11, Χ2/df=1.1; RMSEA=0.023; CFI=0.991; TLI=0.983). Among subjects with co-existing sleep and depressive symptoms, improvement in daytime functioning was predominantly related to improvement in depressive symptoms. Nighttime sleep only related to daytime dysfunction that was specific to sleep disturbances. The phenomenon could be regarded as a primary link. More works are required to understand “sleep-specific” daytime impairments and their roles in the course of concurrent sleep and mood disturbances. NA

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