Trouble Sleeping and Depression Among US Women Aged 20 to 30 Years

Rifath Ara Alam Barsha, MBBS, MPH; Mian B. Hossain, PhD, MHS, MS


Prev Chronic Dis. 2020;17(4):e29 

In This Article

Abstract and Introduction


Introduction: Depression in women is common, and 1 woman in 4 is likely to have an episode of major depression at some point in her life. Sleep disturbances, which are significantly associated with depression, are increasingly recognized as a determinant of women's health and well-being. Although studies have examined the association between depression and sleep disorders, little research has explored this association among young women. Our study investigated the relationship between sleep problems and depression among women aged 20 to 30.

Methods: We used data on 1,747 women from the US National Health and Nutrition Examination Survey (NHANES) 2009–2016. In addition to univariate and bivariate analysis, we used unadjusted and adjusted logistic regression models to estimate depression in the previous 2 weeks among women who reported ever having trouble sleeping.

Results: Of 1,747 study participants, 19.6% reported trouble sleeping and 9.3% reported symptoms of depression. Weighted logistic regression results showed that women who had trouble sleeping were more than 4 times (odds ratio, 4.36; 95% confidence interval, 3.06–6.21; P < .001) more likely than women who did not have trouble sleeping to have had depression in the previous 2 weeks. The results were similar (adjusted odds ratio, 4.11; 95% confidence interval, 2.78–6.06; P < .001) after adjusting for other covariates.

Conclusion: We found a significant relationship between trouble sleeping and depression among US women aged 20 to 30. Findings suggest the need for regular screening and treatment of sleep disturbances among young women, which may improve their psychological health and reduce depression.


Depression is one of the most common psychiatric disorders. In the United States, depressive disorders were the second leading cause of years lived with disability in 2010.[1] Women are more likely to have depression than men. During 2013–2016, 10.4% of US women aged 20 or older had depression in a given 2-week period and were almost twice as likely as men (5.5%) to have had depression.[2] Although this sex difference persists throughout the female lifespan, it seems to vary according to reproductive stage (puberty, the week or so before menstruation, after pregnancy, and perimenopause).[3] Female hormonal fluctuation may be a trigger for depression.[3] Depression is associated with decreased physical, cognitive, and social function; it is often chronic and impairs quality of life.[4] Depression is predicted to be the leading cause of disease burden by 2030, and it is already the leading cause of disease burden in young adult women worldwide.[3] Therefore, treatment and prevention of depression have become an important topic in the field of public health.

Sleep is an important determinant of a person's overall health and well-being. Sleep, as a critical health-related factor, plays a role in the development of many diseases and even all-cause mortality.[5] Sleep disturbance is one of the most common health complaints among young adults.[6,7] Although 7 to 9 hours of sleep per night on weeknights is recommended for young and midlife adults,[8] 40% of US adults have reported fewer than 7 hours of sleep per night.[9] Of young adults aged 19 to 29, 67% reported not getting enough sleep to function properly.[10] Many psychosocial, biological, and environmental factors contribute to insufficient sleep and sleep disturbance among young adults. The high prevalence of sleep-related disturbances may be partially due to increased academic, social, and work demands.[11] Female sex is also a risk factor for sleep problems. Several studies showed that young adult women are twice as likely as young men to have poor sleep.[12,13] Thus, young women appear to be a particularly vulnerable population to both sleep problems and depression.

Previous studies suggested an association between depression and sleep disturbances in older people[14,15] and an association between sleep disturbances and poor quality of life among women.[16] Less research has been conducted among young adults, who are at particular risk of sleep problems and alterations in circadian timing as a result of developmental and social influences. This age group is at an important stage of life, when early interventions or treatment of sleep problems may have clinical implications. Little research has explored the relationship between sleep and depression among young women, even though the correlates of depression may differ between young women and older women. Understanding the relationships between sleep and depression and correlates among young women may increase the potential to intervene and improve mental health outcomes before they become clinically concerning. The objective of our study was to assess the relationship between trouble sleeping and depression among US women aged 20 to 30 and to determine whether trouble sleeping increased the odds of depression in this population. We hypothesized that ever having trouble sleeping would be associated with depression among women in this age group.