Use of selective serotonin reuptake inhibitors and sleep disturbances in community-dwelling older women.
OBJECTIVE
To determine the association between use of selective serotonin reuptake inhibitors (SSRIs) and objective measures of sleep disturbances in older community-dwelling women, including women without evidence of depression.


METHODS
Cross-sectional study.


METHODS
Four U.S. clinical centers.


METHODS
Two thousand eight hundred fifty-three women aged 71 and older (2,630 nonusers of antidepressants and 223 taking SSRIs alone, not in combination with other antidepressants).


METHODS
Medication use, assessed using an interviewer-administered questionnaire with verification of use from medication containers and computerized dictionary used to categorize type of medication; evidence of depression assessed using self-report or a score of 6 or higher on the Geriatric Depression Scale; and sleep parameters measured using a wrist actigraph, with data collected for an average of four consecutive 24-hour periods.


RESULTS
Of the overall cohort of 2,853 women and of 2,337 women without evidence of depression, sleep disturbances were more common in women taking SSRIs than in those not taking antidepressants. After excluding women with evidence of depression and adjusting for multiple potential confounders, women taking SSRIs were more likely to have a sleep duration of 5 hours or less (multivariate odds ratio (MOR)=2.15, 95% confidence interval (CI)=1.04-4.47), sleep efficiency less than 70% (MOR=2.37, 95% CI=1.32-4.25), sleep latency of 1 hour or more (MOR=3.99, 95% CI=2.29-6.96) and eight or more long wake episodes (MOR=1.75, 95% CI=0.99-3.10).


CONCLUSIONS
SSRI use by older women, including those without evidence of depression, is associated with a greater likelihood of sleep disturbances, including poorer sleep efficiency, longer sleep latency, and sleep fragmentation, manifested by multiple long wake episodes. These results add to the uncertainty regarding risks and benefits of SSRI use in aged populations.
Ensrud
Kristine E
KE
Center for Chronic Disease Outcomes Research, Veterans Affairs Medical Center, Minneapolis, and Department of Medicine and Division of Epidemiology, University of Minnesota 55417, USA. ensru001@.umn.edu
Blackwell
Terri L
TL
Ancoli-Israel
Sonia
S
Redline
Susan
S
Yaffe
Kristine
K
Diem
Susan
S
Claman
David
D
Stone
Katie L
KL
D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000008:administration & dosage; D016022:Case-Control Studies; D015331:Cohort Studies; D003866:Depressive Disorder / Q000188:drug therapy / Q000453:epidemiology; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D012111:Residence Characteristics; D017367:Selective Serotonin Reuptake Inhibitors / Q000008:administration & dosage*; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000453:epidemiology*
D000928:Antidepressive Agents; D017367:Selective Serotonin Reuptake Inhibitors