Effect of depression, anxiety, and rumination on sleep quality in healthcare workers

INTRODUCTION: Depression, anxiety and sleep problems are commonly seen among healtcare workers. This study aimed to evaluate the relationship between rumination, anxiety, depression, and sleep quality in healthcare workers and find which factors affect sleep quality in this population
METHODS: Participants (n=373)were evaluated with The Hospital Anxiety Depression Scale (HADS), the Pittsburgh Sleep Quality Index (PUKİ), and The Ruminative Thought Style Questionnaire (RDBÖ).
RESULTS: The mean age of the participants was 35,83 ± 9,75 and 267 (71.6 %) were female. Within the whole group; 198 (53.1%) of them had poor sleep and 175 (46.9%) had good sleep quality. About HADS scores, 173 (46.4%) had minimal, 100 (26.8%) had borderline anxiety and 100 (26.8%) had abnormal anxiety scores; 224 (60.1) had minimal, 87 (23.3%) had borderline depression and 62 (16.6%) had abnormal depression scores. Participants having poor sleep according to PSQI had significantly higher HADS-A, HADS-D, and RTSQ scores compared to good sleepers (p<0.001, p<0.001, and p<0.001 respectively). Individuals who scored above average on the RTSQ scale had significantly higher PSQI, HADS-A, and HADS-D scores compared to individuals having scores below average on the RTSQ (p<0.001, p<0.001, and p<0.001). Regression analysis showed that HADS-A and HADS-D contributed more than all other variables for predicting sleep quality in the present study.
DISCUSSION AND CONCLUSION: Poorer sleep is associated with higher anxiety and depression scores. Higher rumination is associated with higher anxiety, depression, and worse sleep. The best predictors of sleep quality in healthcare workers are depression and anxiety scores according to HADS.