A Multilevel Mediation Model to Investigate the Effect of Sleep Quality as a Mediation Factor on the Association between Secondhand Smoking and Depressive Symptoms

Volume 2 - Issue 1

Alfred K Mbah*

Received: December 17, 2019;   Published: January 08, 2020

DOI: 10.26717/CTBB.MS.ID.000130

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Abstract

We investigate in this study the impact of sleep quality as a mediating factor in the association between second hand smoking and depressive symptoms. The study included 196 pregnant women interviewed during and after pregnancy. A multilevel mediation model was applied to the data. Our results suggested that exposure to second hand smoking (ETS) positively predicted sleep quality 0.314, 95% CI [0.124, 0.504], ρ = 0.001 .
In turn, sleep quality was positively related to the depressive symptoms 0.551, 95% CI [0.122, 0.98], ρ = 0.012 . As a result, the between-cluster indirect effect of ETS on depressive symptoms was 0.173 (= 0.314 × 0.551). The distribution of the product of the coefficients 95% CI for the indirect effect was [0.028, 0.375], which did not contain zero. This indicates that the indirect effect of ETS on depressive symptoms through sleep quality was significantly different from zero. Therefore, the results show that the association of ETS on depressive symptoms was completely mediated by sleep quality. These findings highlight the need to develop interventions for pregnant women who are exposed to low sleep quality. Reducing exposure to environmental tobacco smoke in the antepartum period may be an important step in mitigating the risk of peri-natal and post-patum depression among vulnerable populations. We think that improving sleep architecture may improve the quality of life for pregnant women and their infant.

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