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J Am Geriatr Soc. 2012 Apr;60(4):635-43. doi: 10.1111/j.1532-5415.2012.03908.x. Epub 2012 Mar 16.

Depressive symptoms and subjective and objective sleep in community-dwelling older women.

Author information

  • 1Department of Psychiatry, University of California at San Diego, La Jolla, California, USA. jmaglione@ucsd.edu

Abstract

OBJECTIVES:

To examine the relationship between depressive symptoms and subjective and objective sleep in older women.

DESIGN:

Cross-sectional.

SETTING:

Four U.S. clinical centers.

PARTICIPANTS:

Three thousand forty-five community-dwelling women aged 70 and older.

MEASUREMENTS:

Depressive symptoms were assessed using the Geriatric Depression Scale, categorizing participants as normal (0-2, reference), some depressive symptoms (3-5), or depressed (≥ 6). Subjective sleep quality and daytime sleepiness were assessed using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Objective sleep measures were assessed using wrist actigraphy.

RESULTS:

In multivariable-adjusted models, there were graded associations between greater level of depressive symptoms and worse subjective sleep quality and more subjective daytime sleepiness (P-trends < .001). Women with some depressive symptoms (odds ratio (OR) = 1.82, 95% confidence interval (CI) = 1.48-2.24) and depressed (OR = 2.84, 95% CI = 2.08-3.86) women had greater odds of reporting poor sleep (PSQI>5). Women with some depressive symptoms (OR = 1.97, 95% CI = 1.47-2.64) and depressed women (OR = 1.70, 95% CI = 1.12-2.58) had greater odds of reporting excessive daytime sleepiness (ESS>10). There were also graded associations between greater level of depressive symptoms and objectively measured wake after sleep onset (WASO) (P-trend = .03) and wake episodes longer than 5 minutes (P-trend = .006). Depressed women had modestly higher odds of WASO of 1 hour or longer (OR = 1.37, 95% CI = 1.03-1.83). Women with some depressive symptoms (OR = 1.49, 95% CI = 1.19-1.86) and depressed women (OR = 2.04, 95% CI = 1.52-2.74) had greater odds of being in the highest quartile for number of nap episodes longer than 5 minutes. No associations between depressive symptom level and prolonged sleep latency, poor sleep efficiency, or short or long total sleep time were found.

CONCLUSION:

Greater depressive symptom levels were associated with more subjective sleep disturbance and objective evidence of sleep fragmentation and napping.

© 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

PMID:
22428562
[PubMed - indexed for MEDLINE]
PMCID:
PMC3517685
Free PMC Article

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