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Ying Huang,1 Meilan Zhu2 1Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, People’s Republic of China; 2Department of Rehabilitation, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, People’s Republic of ChinaCorrespondence: Meilan ZhuDepartment of Rehabilitation, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Donghu District, Nanchang City, Jiangxi 330006, People’s Republic of ChinaEmail zhumeilan88033@163.comBackground: Although sleep problems are associated with a wide range of mental problems, it remains uncertain whether the global Pittsburgh Sleep Quality Index (PSQI) score is related to depressive symptoms in an adult population.Patients and Methods: Data from the Midlife in the United States (MIDUS) study, including a general adult population, were obtained. A total of 1002 individuals (aged 34– 84 years) were included in this study. Linear regression and logistic regression analyses were performed to investigate the association between sleep parameters from the PSQI score and depressive symptoms.Results: The median age of all participants was 53.0 years old, and 45.2% of them were male. After adjustments were made for sociodemographic characteristics, lifestyle factors, currently diagnosed diseases and inflammatory markers, global PSQI score was significantly associated with depression score in the linear regression model (0.298 [0.207– 0.389], P< 0.001; Model 3). A higher global PSQI score was independently and significantly associated with depressive symptoms (score ≥ 16) in the logistic regression model (1.235 [1.150– 1.325], P< 0.001; Model 3). Stratified analysis showed that the independent association between global PSQI score and depressive symptoms was affected by hypnotics use, but not antidepressants use.Conclusions: A higher global PSQI score is significantly associated with a higher risk of depressive symptoms in an adult population from the United States. Future longitudinal and interventional studies are warranted to assess whether reducing the global PSQI score may improve symptoms of depression.Keywords: Pittsburgh Sleep Quality Index, depression, cross-sectional study

Ying Huang,1,* Ying Jiang,2,* Meilan Zhu2 1Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, People’s Republic of China; 2Department of Rehabilitation, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi 330006, People’s Republic of China*These authors contributed equally to this workCorrespondence: Meilan ZhuDepartment of Rehabilitation, The Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Donghu District, Nanchang, Jiangxi 330006, People’s Republic of ChinaEmail 15070896289@139.comBackground: Poor sleep is a risk factor for cardiovascular diseases (CVDs). The underlying pathogenesis is not clear. Levels of inflammatory markers, such as C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor-ɑ (TNF-ɑ), have been found to be elevated in patients with CVDs.Aim: The study aimed to investigate the associations between sleep quality and serum inflammatory markers in a cohort of obese adults.Methods: This was a second analysis of the data from the Midlife in the United States (MIDUS) study, a longitudinal study of a national (US) sample of adults. A total of 1255 participants completed comprehensive biological assessments. The associations between global sleep score and serum levels of inflammatory markers were analyzed.Results: Univariate analysis showed that a higher global sleep score was correlated with lower age (r = −0.079, P= 0.009), higher BMI (r = 0.100, P= 0.001) and heavier perceived stress (r = 0.335, P