The relationship between depression and sleep disturbances: a Japanese nationwide general population survey.
OBJECTIVE
Among the existing epidemiologic studies that have examined the relationship between depression and sleep disturbances, there are few nationwide studies that have been conducted on subjects representing the general population. The present study was therefore conducted to clarify the relationship between depression and sleep disturbances, in particular the relationship between depression and both sleep duration and subjective sleep sufficiency, using a large sample representative of the general population.


METHODS
The survey was conducted in June 2000, using self-administered questionnaires, targeting a population that was selected randomly from among 300 communities throughout Japan. Among the respondents, data from 24,686 individuals aged 20 years or older were analyzed. The Center for Epidemiologic Studies Depression Scale was used to assess the presence of depression. Sleep status, including sleep duration, subjective sleep sufficiency, and the presence or absence of insomnia symptoms, was evaluated.


RESULTS
Those whose sleep duration was less than 6 hours and those whose sleep duration was 8 hours or more tended to be more depressed than those whose sleep duration was between 6 and 8 hours. Thus, sleep duration exhibited a U-shaped association with symptoms of depression. As subjective sleep sufficiency decreased, symptoms of depression increased, indicating a linear inverse-proportional relationship.


CONCLUSIONS
The fact that sleep duration and subjective sleep sufficiency exhibited different relationships with symptoms of depression indicates that these 2 sleep parameters each have their own significance with regard to depression. These findings may be useful in the medical management of mental diseases.
Department of Public Health, School of Medicine, Nihon University, Tokyo, Japan. kaneita@med.nihon-u.ac.jp
Yoshitaka
Y
Kaneita
Takashi
T
Ohida
Makoto
M
Uchiyama
Shinji
S
Takemura
Kazuo
K
Kawahara
Eise
E
Yokoyama
Takeo
T
Miyake
Satoru
S
Harano
Kenshu
K
Suzuki
Toshiharu
T
Fujita
D000328:Adult; D017677:Age Distribution; D000368:Aged; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory / Q000706:statistics & numerical data; D011156:Population Density; D015995:Prevalence; D017678:Sex Distribution; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000453:epidemiology; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000453:epidemiology*; D011795:Surveys and Questionnaires