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Physical Activity, Sleep, and Symptoms of Depression in Adults—Testing for Mediation

KASEVA, KAISA1; DOBEWALL, HENRIK1,2; YANG, XIAOLIN3; PULKKI-RÅBACK, LAURA1,4; LIPSANEN, JARI1; HINTSA, TAINA1,5; HINTSANEN, MIRKA1,6; PUTTONEN, SAMPSA1; HIRVENSALO, MIRJA7; ELOVAINIO, MARKO1; RAITAKARI, OLLI8,9; TAMMELIN, TUIJA3

Medicine & Science in Sports & Exercise: June 2019 - Volume 51 - Issue 6 - p 1162–1168
doi: 10.1249/MSS.0000000000001896
EPIDEMIOLOGY
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Purpose Physical activity, sleep problems, and symptoms of depression contribute to overall well-being. The factors are reciprocally associated, but the nature of these associations remains unclear. The present study examined whether sleep problems mediated the association between physical activity and depressive symptoms.

Methods The eligible population (n = 3596) consisted of adults from the ongoing, population-based Cardiovascular Risk in Young Finns Study started in 1980. Participants’ leisure-time physical activity was assessed with physical activity index (2007) and sleep problems with Jenkins’ Sleep Questionnaire in 2007 and 2011. Depressive symptoms were measured using modified Beck Depression Inventory in 2007 and 2012, from which the items reflecting sleep problems were excluded. Mediation analyses, through which the associations between the variables were examined, were adjusted for sex and a set of health-related covariates assessed in 2007 and 2011.

Results Physical activity was associated with decreased levels of sleep problems and depressive symptoms (P < 0.05). The association between physical activity and depressive symptoms (b = −0.10, P < 0.01) was partly mediated by sleep problems (proportion mediated = 0.36, P < 0.01). The adjustment for depressive symptoms at baseline attenuated the mediation effect (proportion mediated = 0.30, P > 0.05).

Conclusions Physical activity’s favorable contribution to depressive symptoms was mediated partly by sleep, but the mediation effect disappeared after adjusting for the previous depressive symptoms in adulthood.

1Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, FINLAND;

2Faculty of Social Sciences, Health Sciences, Tampere University, Tampere, FINLAND;

3LIKES Research Centre for Physical Activity and Health, Jyväskylä, FINLAND;

4Helsinki Collegium for Advanced Studies, University of Helsinki, Helsinki, FINLAND;

5School of Educational Sciences and Psychology, University of Eastern Finland, FINLAND;

6Unit of Psychology, University of Oulu, Oulu, FINLAND;

7Department of Sport Sciences, University of Jyväskylä, Jyväskylä, FINLAND;

8Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, FINLAND; and

9Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, FINLAND

Address for correspondence: Kaisa Kaseva, Ph.D., Department of Psychology and Logopedics, P.O. Box 9, 00014 University of Helsinki, Finland; E-mail: kaisa.kaseva@helsinki.fi.

Submitted for publication May 2018.

Accepted for publication January 2019.

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© 2019 American College of Sports Medicine