Serious Psychological Distress and Sleep Duration in Five States

Background: Improving mental health through prevention and increasing public knowledge of how adequate sleep improves health are Healthy People 2020 goals. Serious psychological distress (SPD) is associated with depression, anxiety, and mood disorders. However, it is not known whether SPD is linked to short sleep duration or long sleep duration in the general population. We examined these associations in a population-based sample.

Methods: We analyzed cross-sectional data from 36,859 US adults aged 18 years or older in the 2013 Behavioral Risk Factor Surveillance System (BRFSS). SPD was assessed using the Kessler 6 (K6) scale of nonspecific psychological distress ranging from no symptoms to clinically significant symptoms. Five states (Colorado, Minnesota, Nevada, Tennessee, and Washington) included the optional BRFSS mental illness and stigma module including the K6 scale. To estimate prevalence ratios (PR) for the associations of self-reported SPD with short sleep duration (≤ 6 hours) and long sleep duration (≥ 9 hours), Poisson regression models with robust variance were used, adjusting for age, gender, race/ethnicity, marital status, educational attainment, income, employment, and health insurance coverage.

Results: Overall, 4.0% of adults reported SPD, 33.9% reported short sleep, and 7.8% reported long sleep. Compared to those who did not report SPD, adults with SPD were significantly more likely to report short sleep (PR=1.56, 95% CI: 1.43, 1.69) and long sleep (PR=1.42, 95% CI: 1.10, 1.83) controlling for sociodemographic characteristics.

Conclusions: Our study found that adults with SPD are more likely to report both short sleep duration and long sleep duration, highlighting the need for interventions that promote mental health and sufficient sleep. Future research to determine the temporal associations between SPD and sleep duration is necessary for developing and offering effective interventions.