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Abstract Introduction To examine the interaction effects of sleep duration and trouble sleeping on depression among U.S. adults. Methods We used data from the National Health and Nutrition Examination Survey (NHANES) from 2015 to 2018 (N=10,044). Trouble sleeping was self-reported. Sleep duration was determined as short (≤ 6 hours) or long (≥ 9 hours), compared with normal (6 and 9 hours). Depressive symptoms were defined as the Patient Health Questionnaire-9 score ≥ 10. Both multiplicative interaction and additive interaction were assessed. Results A significant positive additive interaction between short sleep duration and trouble sleeping on depression was observed in the fully adjusted model (Relative excess risk due to interaction, RERIOR=4.42, 95% CI: 1.12, 7.73), with 43% of the association with depression attributed to the interaction (attributable proportion of interaction, AP=0.43, 95% CI: 0.22, 0.64). Similarly, there was a significant positive additive interaction between long sleep duration and trouble sleeping on depression after adjustment (RERIOR= 4.17, 95% CI: 0.96, 7.38), with 41% of the association with depression attributed to the interaction (AP=0.41, 95% CI: 0.21, 0.60). No multiplicative interaction between short or long sleep duration and trouble sleeping was detected. Conclusion Different aspects of sleep health interact synergistically, accounting for a substantial portion of the association with depression. It is crucial to simultaneously consider multiple dimensions of sleep health when examining their relationship with depression. Support (if any)
Wang et al. (Sat,) studied this question.