Depressive symptoms mediate the association between dietary inflammatory index and sleep: A cross-sectional study of NHANES 2005-2014.

Abstract

Background: Sleep pattern (sleep duration, trouble sleeping, sleep disorder) is associated with both energy density dietary inflammatory index (EDII) and depression. However, whether depression mediates the EDII-sleep pattern relationship is unclear.

Methods: 14,305 participants from the National Health and Nutrition Examination Survey (NHANES) from 2005 to 2014 were included in this study. Weighted multivariable logistic regression and mediated effect analysis were conducted to analyze the associations between EDII, depression and sleep pattern.

Results: In the regression model with full confounding variables adjusted, the OR (95 % CI) for the association between EDII and sleep pattern was 2.11 (1.44, 3.08). Similarly, comparing the highest to the lowest EDII scores, the association with depression yielded an identical OR of 2.62 (1.89, 3.64). Mediation models showed depressive symptoms mediated 24.06 % of the EDII-sleep pattern link. Analysis by sleep pattern subtypes found depressive symptoms mediated 18.22 % for sleep duration, 30.53 % for sleep disorder (both with substantial direct EDII effects), and 93.73 % for trouble sleeping, where EDII's direct impact was not considerable.

Conclusion: Positive association of EDII with unhealthy sleep pattern is partly mediated by depression, and anti-inflammatory diet could be beneficial.