Association between depressive symptoms and sleep disturbances in community-dwelling older men.
OBJECTIVE
To examine the association between depressive symptoms and subjective and objective measures of sleep in community-dwelling older men.


METHODS
Cross-sectional.


METHODS
Six U.S. clinical centers.


METHODS
Three thousand fifty-one men aged 67 and older.


METHODS
Depressive symptoms assessed using the 15-item Geriatric Depression Scale and categorized as 0 to 2 (normal, referent group), 3 to 5 (some depressive symptoms), and 6 to 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 and Epworth Sleepiness Scale.


RESULTS
There was a strong multivariable-adjusted association between level of depressive symptoms and subjective sleep disturbances (P-trend <.001). For example, the odds of reporting poor sleep quality were 3.7 times (95% confidence interval (CI)=2.5-5.3) higher for depressed men as for normal men, and 2.1 times (95% CI=1.7-2.6) higher for men with some depressive symptoms. For objectively measured sleep disturbances, men with more depressive symptoms had greater odds of sleep latency of 1 hour or more (P-trend=.006). There was no association between level of depressive symptoms and sleep efficiency, awakening after sleep onset, multiple long-wake episodes, or total sleep time. Excluding 384 men taking antidepressants, benzodiazepines, or other anxiolytic or hypnotics did not alter the results.


CONCLUSIONS
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.
Paudel
Misti L
ML
Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA. ames0047@umn.edu
Taylor
Brent C
BC
Diem
Susan J
SJ
Stone
Katie L
KL
Ancoli-Israel
Sonia
S
Redline
Susan
S
Ensrud
Kristine E
KE
D000368:Aged; D000369:Aged, 80 and over; D000928:Antidepressive Agents / Q000627:therapeutic use; D003863:Depression / Q000145:classification / Q000150:complications* / Q000188:drug therapy; D015577:Geriatric Assessment / Q000379:methods*; D006304:Health Status; D006801:Humans; D008297:Male; D015995:Prevalence; D012890:Sleep; D012893:Sleep Wake Disorders / Q000209:etiology*; D014481:United States / Q000453:epidemiology
D000928:Antidepressive Agents