Association between sleep problems and depressive symptoms among small-scale miners in Ghana

• Sleep problems predict depression risk among Ghanaian small-scale miners. • Emotional distress and anxiety partially mediate this sleep–depression link. • Study highlights diagnostic value of sleep health in mental health screening. • Findings highlight the need for sleep-focused care in resource-poor settings. • Results inform pathophysiology of depression via sleep and emotional pathways. Sleep problems (SP) are increasingly linked to poor mental health outcomes, yet limited research has explored this association among high-risk occupational groups in low- and middle-income countries (LMICs). We investigate the association between SP and depressive symptoms among small-scale miners in Ghana and explores whether emotional distress and anxiety explain this association. We recruited 664 miners (mean age = 28.8, SD = 8.2 years; males = 84.3 %) in this study. SP was assessed using the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0), while depressive symptoms were measured using the PHQ-9. Emotional distress and anxiety were assessed using the MOS SF-36 scale and the GAD-7 scale, respectively. Multiple linear regressions and bootstrapping techniques evaluated the hypothesized direct and indirect associations. SP was significantly associated with higher levels of depressive symptoms (B = 0.171, p < 0.001), after adjustment. Crucially, emotional distress (53.06 %; B = 0.2447, 95 % CI [0.1739, 0.3221]), and anxiety (25.0 %; B = 0.1153, 95 % CI [0.0592, 0.1745]) partially accounted for the association between SP and depressive symptoms. Poor sleep quality may be a clinical marker for depressive symptoms among small-scale miners, with emotional distress and anxiety as key psychological pathways. Integrated sleep-related screening and intervention strategies is needed in poor occupational health settings. Nevertheless, given the non-probability sampling approach used, some degree of selection bias cannot be ruled out, and findings should be interpreted with caution regarding their generalizability beyond the study communities.