Abstract Body (Do not enter title and authors here): Introduction: Poor sleep is associated with adverse mental and cardiometabolic health outcomes. However, there are limited data on the interplay between insomnia and psychological distress domains and their influence on adiposity indicators among women.
Aims: To evaluate associations of psychological distress domains with adiposity indicators and elucidate differences by insomnia status in a racially and ethnically diverse cohort of women.
Hypothesis: We hypothesized that psychological distress would be associated with worse anthropometric indicators of adiposity and that insomnia would exacerbate these relations.
Methods: This is a cross-sectional study of a community-based cohort of 237 women (69% racial/ethnic minority, 34.1±13.5y). Validated questionnaires assessed perceived stress (4-item Perceived Stress Scale), chronic stress (4-item Global Perceived Stress Scale), stressful life events exposure within the past year (8-item Life Events Checklist), and depression (2-item Patient Health Questionnaire). Insomnia was assessed using the validated Insomnia Severity Index, and BMI and waist circumference (WC) were measured by trained study personnel. Linear regression models adjusted for age and socioeconomic status examined associations of psychological distress with BMI and WC in the overall sample and by insomnia status.
Results: There were no significant associations between psychological distress and anthropometric markers of adiposity in the overall sample. Although a statistically significant interaction between insomnia and stressful life events was observed (p-interaction<0.05), in stratified analyses, higher exposure to stressful life events was more strongly associated with higher BMI and WC among individuals with vs. without insomnia (BMI: β=1.17±0.97 vs. 0.05±0.26 and WC: β=1.23±0.75 vs. -0.07±0.25), but these associations were not significant (p>0.05). Notably, associations of chronic stress with BMI varied by insomnia status (p-interaction=0.052). Specifically, higher chronic stress was associated with lower BMI (β=-1.55±0.72, p=0.044) among individuals with insomnia, but null results were observed among those without insomnia (β=0.07±0.16, p=0.66).
Conclusions: Insomnia may moderate the association of stress with adiposity indicators. These findings highlight the complexity of the relations between sleep disorders, stress, and obesity risk and warrant replication in a larger sample and among males.