Arch Clin Neuropsychol. 2023 Oct 8:acad067.014. doi: 10.1093/arclin/acad067.014. Online ahead of print.
OBJECTIVE: Depression and sleep disturbance often co-occur, and both have been found to negatively impact cognitive functioning. This study aims to examine sleep as a potential mediator between depression and cognitive functioning in college athletes.
METHOD: 897 collegiate athletes (F = 230) completed a comprehensive neuropsychological battery including self-reported symptom measures. The Beck Depression Inventory-Fast Screen was used to measure depression, and the Post-Concussion Symptom Scale (PCSS) sleep cluster was used to quantify sleep disturbance. Depression was examined dichotomously (depressed/non-depressed). Neurocognitive functioning was examined via z-score composites of attention/processing speed (A/PS) and memory. Two mediation analyses, with depression as the independent variable, sleep disturbance as the mediator, and A/PS or memory performance as outcomes were conducted using the SPSS PROCESS macro, with 5000 bootstrap samples and 95% confidence interval.
RESULTS: In the first mediation, depression was significantly associated with poorer A/PS performance (ß = -0.13, p = 0.02) and greater sleep disturbance (ß = 1.89, p < 0.001). Sleep disturbance was also negatively associated with A/PS performance (ß = -0.01, p = 0.03). After controlling for sleep disturbance, the relationship between depression and A/PS performance became non-significant (ß = -0.10, p = 0.08, indirect effect = -0.08, 95%CI[-0.057,-0.004]), indicating mediation via sleep disturbance. In the second mediation model, depression was not significantly associated with memory performance, so the mediation was discontinued.
CONCLUSIONS: Sleep disturbance fully mediated the relationship between depression and A/PS performance. This suggests that sleep problems account for the relationship between depression and A/PS. Future work should examine interventions aimed at improving sleep in depressed college athletes which may translate to better academic and athletic performance through improved attention and processing speed.