Investigating the Moderating Role of Sleep Quality to Depression and Loneliness After Stroke

Abstract: Loneliness and depression occur frequently after stroke, and sleep difficulties often co-occur with both symptoms. This cross-sectional study used Health and Retirement Study Wave 15 data collected in 2020 and included 346 stroke survivors. Hierarchical linear regression models tested whether sleep difficulties moderated the association between depression and loneliness after adjustment for age, sex, race, income, education, and chronic disease burden. Higher depressive symptoms related to higher loneliness, and better sleep related to lower loneliness. The depression × sleep difficulties interaction was not significant, and no individual sleep indicator showed evidence of moderation. Younger age, fewer education years, greater chronic disease burden, and the “Other” racial group related to higher loneliness. These findings supported independent associations of depression and sleep difficulties with loneliness after stroke, but did not support moderation.