Association between depression, sleep disturbance, and irregular menstrual cycles: insights from the NHANES 2005–2018

Abstract

Introduction: This paper examines the connection among sleep disturbances, depressive symptoms, and menstrual cycle irregularities. Given the high prevalence of sleep disturbances and depression among women of reproductive age, understanding their impact on menstrual cycles is crucial for developing effective interventions. Methods: NHANES data of American women from 2005 to 2018 were utilized. Weighted multivariate logistic regression models were utilized to estimate the odds of menstrual irregularities in relation to depressive symptoms, sleep disturbances, and their combined effects. Restricted cubic spline analyses were used to assess potential nonlinear relationships. Subgroup analyses were conducted based on demographic and lifestyle factors. Mediation analysis was performed to evaluate the potential indirect pathways through fasting blood glucose (FBG) and triglycerides (TG). Results: Three thousand five hundred ninety-four participants were included in adjusted analyses. Both depressive symptoms (OR = 1.58; 95% CI: 1.13–2.23) and sleep disturbance (OR = 1.69; 95% CI: 1.23–2.34; P = 0.002) were associated with higher odds of menstrual irregularities. Participants with both sleep disturbances and depressive symptoms had higher odds of menstrual irregularities (OR = 1.86; 95% CI: 1.29–2.67; P = 0.001). In mediation analyses, the indirect association via FBG accounted for 1.56% of the total association, and the indirect association via TG accounted for 4.31%. Conclusion: Sleep disturbances and depressive symptoms were independently and jointly associated with higher odds of menstrual irregularities, and the risk was higher when both were present. Statistically significant indirect associations were observed via FBG and TG.