title: Association between depressive symptoms and sleep disturbances in community-dwelling older men.
abstract: 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.
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, Minnesota, USA. ames0047@umn.edu
authors.forename: Misti L
authors.initials: ML
authors.lastname: Paudel
authors.forename: Brent C
authors.initials: BC
authors.lastname: Taylor
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Diem
authors.forename: Katie L
authors.initials: KL
authors.lastname: Stone
authors.forename: Sonia
authors.initials: S
authors.lastname: Ancoli-Israel
authors.forename: Susan
authors.initials: S
authors.lastname: Redline
authors.forename: Kristine E
authors.initials: KE
authors.lastname: Ensrud
mesh_terms: 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
chemical_list: D000928:Antidepressive Agents