Depression mediates motor dysfunction's effect on sleep quality in ALS: a mediation analysis study

Area of Science:

• Neurology
• Sleep Medicine
• Psychiatry

Background:

• Poor sleep quality affects over half of Amyotrophic Lateral Sclerosis (ALS) patients, worsening their condition and reducing life quality.
• Understanding the interplay between disease progression, mood, and sleep is vital for improving patient outcomes.

Purpose of the Study:

• To investigate the relationships among disease severity, depressive symptoms, and sleep quality in ALS patients.
• To explore the potential mediating role of depression in the association between motor dysfunction and sleep disturbances.

Main Methods:

• 408 ALS patients were assessed for disease severity (ALSFRS-R), sleep quality (PSQI), and psychological status (HAMD, HAMA).
• Statistical analyses included correlation, multivariate regression, and mediation analysis using Hayes' PROCESS macro.
• Specific subscales of ALSFRS-R (motor/respiratory) and PSQI (sleep efficiency/daytime dysfunction) were analyzed for refined correlation and mediation.

Main Results:

• 54.4% of ALS patients reported poor sleep quality.
• Both disease severity (ALSFRS-R) and depressive symptoms (HAMD) were significantly correlated with poorer sleep quality.
• Depression accounted for 36.3% of the indirect effect between motor/respiratory function and sleep quality/daytime dysfunction.

Conclusions:

• Depressive symptoms may partially mediate the relationship between motor impairment and poor sleep in ALS.
• These findings highlight the importance of integrating mental health support into the clinical management of ALS.
• Further longitudinal studies are recommended to confirm the mediating role of depression in ALS progression and sleep disturbances.