Depression, anxiety, and bodily pain independently predict poor sleep quality among adult women attending a primary health center of Puducherry, India

Abstract

Background: Sleep disorders and mental health problems are common diagnoses in primary care settings. The objective of this study was to estimate the magnitude of poor sleep, depression, and anxiety through opportunistic screening and to find out the independent predictors of poor sleep quality among female participants. Materials and Methods: A hospital-based study was conducted in the outpatient department (OPD) of an urban primary health center of Puducherry. Patients and accompanying healthy attendants ≥ 18 years of age who visited the OPD for any reason were included. Those with serious acute illness, previously diagnosed mental illness, pregnant women, and women in postpartum period (upto 6 weeks) were excluded. Systematic random sampling was used to select the participants. A semi-structured questionnaire was used to collect sociodemographic and clinical details along with the Pittsburgh Sleep Quality Index (PSQI) and the Hospital Anxiety and Depression Scale. Height and weight were also measured. Results: A total of 301 participants were recruited. Mean age of the participants was 49.4 (standard deviation 15.2) years. Magnitude of poor sleep (PSQI score > 5), abnormal anxiety, and abnormal depression were 118 (39.2%), 60 (19.9%), and 28 (9.3%) respectively. Multivariate logistic regression analysis showed that history of pain [odds ratio (OR) 3.2 (1.6–6.5), P = 0.001], abnormal anxiety [OR 2.5 (1.2–5.6), P = 0.021], and abnormal depression [OR 4.3 (1.4–13.2), P = 0.01] independently predicted poor sleep quality among females. Conclusion: OPD-based opportunistic screening for sleep and mental health problems should be routinely conducted by primary care and family physicians.

Keywords

• Anxiety
• depression
• primary care
• screening
• sleep