Sleep disturbance and fatigue as depressive symptom expressions among men with chronic obstructive pulmonary disease (COPD): a population-based analysis of NHANES data Sleep, Fatigue, and Depression in Men with COPD
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Abstract
Background: Men with chronic obstructive pulmonary disease (COPD) may underreport mood disturbance and instead present with somatic symptoms. This study aimed to examine the social patterning of sleep disturbance and fatigue as item-level depressive symptoms and their associations with disease burden among men with spirometry-defined COPD.
Methods: Data were obtained from 982 men (mean age = 62 years) in the 2007–2012 U.S. National Health and Nutrition Examination Survey; 58% were Non-Hispanic White, 21% Non-Hispanic Black, 9% Mexican American, 7% Other Hispanic and 5% other/multiracial. Logistic regression assessed associations of race/ethnicity, socioeconomic position, lung function, smoking, and multimorbidity with each symptom.
Results: Older age was associated with lower odds of sleep disturbance, whereas multimorbidity was associated with higher odds (adjusted OR = 1.62, 95% CI [1.09, 2.42]). Fatigue was associated with socioeconomic position, with higher odds among participants in PIR Category 0 compared with Category 3 (adjusted OR = 2.39, 95% CI [1.51, 3.78]), FEV₁/FVC (adjusted OR = 0.11, 95% CI [0.02, 0.81]), smoking status (overall p = .024), and multimorbidity (OR = 1.52, 95% CI [1.05, 2.20]). Race/ethnicity was associated with fatigue (overall p = .001), but not sleep disturbance (overall p = .071).
Conclusion: Sleep disturbance and fatigue showed distinct patterns of association with socioeconomic position and clinical characteristics among men with COPD. Future assessment of these individual depressive symptoms may complement broader depression screening and inform gender-sensitive clinical interventions.
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