Depressive Symptoms, Sleep Complaints, and Cognitive Performance: Examining the Mediating Role of Sleep in College Athletes.

Abstract

Background: Depression and sleep disturbance frequently co-occur, with both negatively affecting cognitive functioning. This study investigated whether sleep disturbance mediates the relationship between depressive symptoms and cognitive performance in college athletes.

Method: 895 collegiate athletes (F = 230) completed comprehensive neuropsychological assessment. Depressive symptoms were assessed using the Beck Depression Inventory-Fast Screen (dichotomized as elevated vs. non-elevated). Sleep disturbance was measured via the Post-Concussion Symptom Scale sleep cluster. Cognitive performance was examined using composites of attention/processing speed (A/PS) and memory. Two mediation analyses examined whether sleep disturbance mediated the effect of depressive symptoms on A/PS and memory. Reverse mediation analyses, with sleep disturbance as the predictor and depressive symptoms as the mediator, were also conducted.

Results: Elevated depressive symptoms were associated with poorer A/PS performance and greater sleep disturbance, which was also negatively associated with A/PS. After accounting for sleep disturbance, the relationship between depressive symptoms and A/PS became non-significant, indicating partial mediation. In reverse mediation, sleep disturbance was associated with poorer A/PS; depressive symptoms did not mediate the effect of sleep disturbance on A/PS. Depressive symptoms were not significantly associated with memory, so the forward mediation was discontinued. In the reverse model, sleep disturbance was associated with poorer memory performance even when controlling for depressive symptoms, thus inconsistent with mediation.

Conclusions: Findings suggest that sleep disturbance partly explains the relationship between depressive symptoms and reduced A/PS in collegiate athletes. Additionally, sleep disturbance is associated with poorer memory performance independently of depressive symptoms. Thus, interventions targeting sleep may benefit athletes' cognitive performance.