Pathways to better sleep: Depression, anxiety, and stress as mediators in the relationship between social support and insomnia severity in Appalachian adults

IF 4.9 2区医学 Q1 CLINICAL NEUROLOGY

Journal of affective disorders Pub Date : 2025-07-14 DOI:10.1016/j.jad.2025.119929

Mairead E. Moloney , Emily Slade , Joon Chung , Kory Heier , Daniela C. Moga

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引用次数: 0

Abstract

Background

Rural Appalachia has some the highest rates of sleep and health disparities in the United States.

This study investigates the relationship between social support and insomnia severity in rural Appalachian adults, with specific attention to the potential mediating roles of depression, anxiety, and stress.

Methods

Participants from 12 rural Eastern Kentucky counties completed validated measures of insomnia severity, social support, depression, anxiety, and perceived stress. Using R, we calculated descriptive statistics and fit mediation models for depressive symptoms, anxiety symptoms, and stress, with social support as the exposure and insomnia severity as the outcome.

Results

Aligning with regional demographics, nearly all participants identified as Caucasian/White (97.4 %) and non-Hispanic/non-Latin (a/o)/non-Latinx (96.8 %). Of 270 participants (mean age: 46 [SD = 13.2], 79.9 % women) 30 % had clinically significant insomnia. Greater social support was associated with lower insomnia severity (r = −0.30, p < 0.001) in unadjusted analyses. Mediation analyses revealed that this relationship was significantly mediated by depressive symptoms (69 %), anxiety symptoms (64 %), and perceived stress (78 %). After accounting for these psychological mediators, the direct effect of social support on insomnia was no longer significant.

Conclusions

Our findings provide valuable insight into the psychological mechanisms linking social support and sleep health in rural Appalachian adults, though generalizability may be limited to similar racially homogeneous, rural populations. Social support influences insomnia symptoms in rural Appalachian adults primarily through psychological pathways, particularly by buffering against stress. Interventions addressing sleep problems in this population should target psychological factors while leveraging existing social resources within the cultural context of Appalachia.

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通往更好睡眠的途径：在阿巴拉契亚成年人中，抑郁、焦虑和压力在社会支持和失眠严重程度之间的关系中起中介作用。

背景：阿巴拉契亚农村地区的睡眠和健康差距在美国是最高的。本研究探讨了阿巴拉契亚农村成年人的社会支持与失眠严重程度之间的关系，并特别关注抑郁、焦虑和压力的潜在中介作用。方法：来自肯塔基州东部12个农村县的参与者完成了失眠严重程度、社会支持、抑郁、焦虑和感知压力的有效测量。我们使用R计算描述性统计，并拟合抑郁症状、焦虑症状和压力的中介模型，以社会支持为暴露，失眠严重程度为结果。结果：与区域人口统计数据一致，几乎所有参与者都被确定为高加索/白人（97.4% %）和非西班牙裔/非拉丁裔(a/o)/非拉丁裔（96.8% %）。在270名参与者中（平均年龄：46岁[SD = 13.2]，女性79.9% %），30 %有临床上明显的失眠。更大的社会支持与更低的失眠严重程度相关（r = -0.30,p ）结论：我们的研究结果为阿巴拉契亚农村成年人的社会支持与睡眠健康之间的心理机制提供了有价值的见解，尽管可推广性可能仅限于类似的种族同质的农村人口。社会支持主要通过心理途径影响阿巴拉契亚农村成年人的失眠症状，特别是通过缓冲压力。解决这一人群睡眠问题的干预措施应该针对心理因素，同时在阿巴拉契亚的文化背景下利用现有的社会资源。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of affective disorders 医学-精神病学

CiteScore

10.90

自引率

6.10%

发文量

1319

审稿时长

9.3 weeks

期刊介绍： The Journal of Affective Disorders publishes papers concerned with affective disorders in the widest sense: depression, mania, mood spectrum, emotions and personality, anxiety and stress. It is interdisciplinary and aims to bring together different approaches for a diverse readership. Top quality papers will be accepted dealing with any aspect of affective disorders, including neuroimaging, cognitive neurosciences, genetics, molecular biology, experimental and clinical neurosciences, pharmacology, neuroimmunoendocrinology, intervention and treatment trials.