title: Testing bidirectional relationships between marital quality and sleep disturbances: a 4-year follow-up study in a Korean cohort.
abstract: OBJECTIVE
  Both poor marital quality and sleep disturbances are risk factors for a broad range of mental and physical health morbidities. The purpose of the study was to investigate bidirectional relationships between marital quality and sleep disturbance and the moderating effects of age and gender.
  
  
  METHODS
  Data from 1081 married individuals who participated in the Korean Genome and Epidemiology Study were analyzed. A marital quality questionnaire and the Pittsburgh Sleep Quality Index were used to assess marital quality and sleep disturbances at baseline and 4-year follow-up. Relevant covariates including sociodemographics, health status, health behaviors, and depressive symptoms were also measured.
  
  
  RESULTS
  Hierarchical multiple regression models revealed that there was a significant interaction between marital quality and age predicting sleep disturbance (P=.017). While there was no association between marital quality and sleep disturbances for the younger group (ages 45-54; n=680), persons with lower marital quality were more likely to have greater sleep disturbances 4 years later for the older group (ages 55-74; n=401). By contrast, sleep disturbance was a significant predictor of marital quality 4 years later, regardless of age or gender (P=.025).
  
  
  CONCLUSIONS
  Poor marital quality is a risk factor for sleep disturbance for older adults but not for middle-aged individuals. In turn, sleep disturbance may lead to lower marital quality for all age groups. Clinicians should be aware of the bidirectional relationships between marital and sleep problems for more effective treatments for both.
authors.affiliation: Institute of Human Genomic Study, Korea University Ansan Hospital, Korea University College of Medicine, Ansan, Republic of Korea.
authors.forename: Hae-Chung
authors.initials: HC
authors.lastname: Yang
authors.forename: Sooyeon
authors.initials: S
authors.lastname: Suh
authors.forename: Hyun
authors.initials: H
authors.lastname: Kim
authors.forename: Eo Rin
authors.initials: ER
authors.lastname: Cho
authors.forename: Seung Ku
authors.initials: SK
authors.lastname: Lee
authors.forename: Chol
authors.initials: C
authors.lastname: Shin
mesh_terms: D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000453:epidemiology / Q000523:psychology; D054541:Family Conflict / Q000523:psychology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D056910:Republic of Korea; D012307:Risk Factors; D012737:Sex Factors; D012893:Sleep Wake Disorders / Q000453:epidemiology* / Q000523:psychology*; D011795:Surveys and Questionnaires