The Effects of Depression and Sleep Quality on Somatic Symptoms in Middle-Aged Women with Cardiovascular Risk Factors

BACKGROUND: This descriptive study investigated the effects of sleep quality and depression on somatization symptoms in middle-aged women with cardiovascular risk factors. METHODS: Data were collected from outpatients who visited three general hospitals and one private hospital in Korea between May 2017 and December 2018. Questionnaires and anthropometric data were used to analyze 144 middle-aged women (45–65 years) with at least one cardiovascular risk factor. SPSS and WIN 21.0 software were used for statistical analysis. To test the mediating effects, the relationships between independent variables and somatic symptoms were compared using the t-test, analysis of variance, and χ(2)-test, and correlations were analyzed using Pearson's correlation coefficient. Finally, multiple linear regression and the Sobel test were used to identify predictors. RESULTS: Somatic symptoms showed a positive correlation with depression (r=46, P<0.001) and a strong negative correlation with sleep quality (r=−52, P<0.001). Depression and sleep quality explained 37% of somatic symptom variance in a multiple linear regression analysis after correcting for age (R(2)=0.37, F=41.53, P<0.001). The Sobel test showed a sleep quality Z-value of 3.78, demonstrating that it was a mediating variable. By adding sleep quality to depressive symptoms, the absolute value of β, which shows the effect's strength, decreased from .49 to .32, confirming a partial mediating effect. CONCLUSION: Depression and sleep quality were predictive of somatic symptoms in middle-aged women with cardiovascular risk factors, and sleep quality had a partial mediating effect on somatic symptoms. To reduce somatic symptoms, strategies that alleviate depression by improving sleep quality are required.