Association Between Depressive Symptoms and Sleep Disturbances in Community-Dwelling Older Men (original) (raw)

Objectives-To examine the association between depressive symptoms, subjective and objective measures of sleep in community-dwelling older men. Design-Cross-sectional Setting-Six US clinical centers Participants-3051 men aged 67 and older Measurements-Depressive symptoms assessed using the 15-item Geriatric Depression Scale and categorized as 0-2 (normal, referent group), 3-5 (some depressive symptoms) and 6-15 (depressed). Objective sleep measures ascertained using wrist actigraphy (mean duration 5.2 nights), and subjective sleep measures assessed using the Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Results-There was a strong multivariable adjusted association between level of depressive symptoms and subjective sleep disturbances (p-trend<0.001). For example, compared with normal men, the odds of reporting poor sleep quality were 3.7-fold (95% CI 2.5 to 5.3) higher for depressed men, and 2.1-fold (95% CI 1.7 to 2.6) higher for men with some depressive symptoms. For objectively measured sleep disturbances, men with a greater level of depressive symptoms had an increased odds of sleep latency ≥1 hour (p-trend=0.006). There was no association between levels of depressive symptoms and reduced sleep efficiency, increased awakening after sleep onset, multiple long-wake episodes or total sleep time. Excluding 384 men taking antidepressants, benzodiazepines or other anxiolytic/hypnotics did not alter the results. Conclusion-Depressive symptoms have a strong, graded association with subjective sleep disturbances; and are moderately associated with objectively measured prolonged sleep latency. Future studies should address temporality of depression and sleep disturbances.