Sleep and happiness in urban-dwelling older adults in Ghana: A serial multiple mediation model of generalized anxiety and depressive symptoms

Razak M. GYASI*, André HAJEK, Richmond OWUSU, Peter Bai JAMES, Mary Sefa BOAMPONG, Burnett Tetteh ACCAM, Kabila ABASS, Ellis OWUSU-DABO, David R. PHILLIPS

*Corresponding author for this work

Research output: Journal PublicationsJournal Article (refereed)peer-review

Abstract

Objective: Sleep problems (SP) are highly prevalent and seriously affect health and well-being in old age. The aim of this study was to examine the association between SP and happiness in an urban-dwelling older sample. We further explore the effects of generalized anxiety and depressive symptoms in the SP-happiness link using serial mediating modeling.

Methods: Data came from the 2016-2018 Aging, Health, Psychological Well-being, and Health-seeking Behavior Study in Ghana (n=661). We measured happiness with the cross-culturally validated item on a five-point scale. The GAD-7 and the CESD-8, respectively, assessed generalized anxiety and depressive symptoms. Participants reported nighttime and daytime SP in the last 30 days. The SPSS-based Hayes' PROCESS macro-program (Model 6) was constructed to quantify the hypothesized mediation effect.

Results: The analysis included 661 adults aged ≥50 years (mean age=65.53 [SD]=11.89 years; 65.20% women). After full adjustment, path models showed that SP was negatively associated with happiness (β=−.1277, 95%CI=−.15950 to −.096). Bootstrapping estimates revealed that SP–happiness link was serially mediated via generalized anxiety representing 8.77%, depressive symptoms yielding 18.95%, and anxiety symptoms→depressive symptoms accounting for 26.70% of the total effect.

Conclusions: Generalized anxiety and depressive symptoms may explain the negative association between SP and happiness in urban-dwelling older adults in the SSA context. Interventions to improve happiness through sleep quality should include mental health. Longitudinal and cross-cultural data are warranted to assess the bi-directionality of this relationship.
Original languageEnglish
JournalAmerican Journal of Geriatric Psychiatry
DOIs
Publication statusE-pub ahead of print - 13 May 2023

Bibliographical note

This work was supported by Lingnan University, Hong Kong [grant number RPG1129310].

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