Association between mindfulness and sleep quality in perimenopausal women: A cross-sectional mediation analysis of depressive symptoms

Table 1 The score of depression, mindfulness level and sleep quality in 693 perimenopausal women, median (interquartile rage)

Item	Score
CES-D	6 (4-9)
MAAS	74 (64-83)
PSQI	6 (4-9)

CES-D: The Short Form of the Center for Epidemiologic Studies Depression Scale; MAAS: Mindful Attention Awareness Scale; PSQI: Pittsburgh Sleep Quality Index.

Table 2 Comparison of depression scores in 693 perimenopausal women with different general data, median (interquartile rage)

Variable	Subgroup	Depression score	H value	P value
Age (years)	< 50	5 (3-8)	6.294	0.012
	≥ 50	6 (4-9)
BMI (kg/m2)	< 18.5	9 (6-10)	9.976	0.018
	18.5 ≤ BMI < 24	6 (4-8.5)
	24 ≤ BMI < 28	6 (4-9)
	≥ 28	5 (3-8)
Ethnicity	Han	6 (4-9)	0.120	0.728
	Other	5.5 (4-9.25)
Educational level	Primary school and below	6 (3-9)	0.382	0.944
	Junior high school	6 (4-9)
	Technical secondary school/senior high school	6 (4-8)
	College and above	5 (4-8)
Smoking status	Current smoker	7 (3-11)	1.602	0.449
	Former smoker	6 (6-8.25)
	Never smoker	6 (4-9)
Drinking status	Current drinker	6 (4-10)	0.869	0.648
	Former drinker	6 (4-8)
	Never drinker	6 (4-9)
Menarche age (years)	Before 15	6 (4-9)	0.042	0.837
	After 15	6 (4-9)
Number of pregnancies	< 5	5 (4-8)	20.74	0.267
	≥ 5	7 (5-11)
Personal income (yuan)	< 2000	6 (4-9)	1.618	0.655
	2000-3999	6 (4-9)
	4000-5999	6 (4-9.5)
	≥ 6000	5 (4-8)
Irregular vaginal bleeding	Yes	6 (4-9)	0.423	0.515
	No	6 (4-8.5)
Menopausal status	Menopausal	6 (4-9)	5.447	0.019
	Non-menopausal	6 (3-8)
Complications	Yes	6 (4-9)	3.935	0.047
	No	6 (4-8)
Surgical history	Yes	5 (4-8)	1.059	0.303
	No	6 (4-9)

BMI: Body mass index.

Table 3 Spearman correlation analysis of depression, mindfulness level and sleep quality in 693 perimenopausal women (r value)

Item	CES-D	MAAS	PSQI
CES-D	1.000a	-0.444a	0.422a
MAAS	-0.444a	1.000a	-0.268a
PSQI	0.422a	-0.268a	1.000a

^aP < 0.01.

CES-D: The Short Form of the Center for Epidemiologic Studies Depression Scale; MAAS: Mindful Attention Awareness Scale; PSQI: Pittsburgh Sleep Quality Index.

Table 4 Multiple linear regression analysis of influencing factors of sleep quality in 693 perimenopausal women

Variable	Subgroup	B	β	t value	P value
MAAS		-0.038	-0.126	-3.346	< 0.001
CES-D		0.320	0.384	10.187	< 0.001
Age (years)	≥ 50	0.677	0.090	2.651	0.008
BMI (kg/m2)	18.5 ≤ BMI < 24	-2.409	-0.326	-2.871	0.004
	24 ≤ BMI < 28	-2.318	-0.303	-2.745	0.006
	≥ 28	-3.217	-0.267	-3.555	0.001
Marital status	Married	0.656	0.105	3.070	0.002
Personal income (yuan)	2000-3999	0.135	0.016	0.438	0.661
	4000-5999	0.788	0.078	2.127	0.034
	≥ 6000	0.797	0.074	2.003	0.046
Number of pregnancies	3-4	0.507	0.068	1.776	0.076
	≥ 5	1.613	0.165	4.231	< 0.001
Complications	No	-0.472	-0.063	-1.842	0.066

MAAS: Mindful Attention Awareness Scale; CES-D: The Short Form of the Center for Epidemiologic Studies Depression Scale; BMI: Body mass index.

Table 5 Mediation effect analysis of depression between mindfulness level and sleep quality in 693 perimenopausal women

Effect type	Effect value	Standard error	95%CI	Effect proportion (%)
Direct effect	-0.101	0.041	-0.181 to -0.021	36.46
Indirect effect	-0.176	0.023	-0.222 to -0.131	63.53
Total effect	-0.277	0.042	-0.359 to -0.195

All path coefficients are statistically significant (P < 0.01). Path coefficients: Mindfulness level to depression (-0.416); depression to sleep quality (0.423); mindfulness level to sleep quality (-0.101). CI: Confidence interval.