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Depressive Symptoms and Subjective and Objective Sleep in Community‐Dwelling Older Women
Author(s) -
Maglione Jeanne E.,
AncoliIsrael Sonia,
Peters Katherine W.,
Paudel Misti L.,
Yaffe Kristine,
Ensrud Kristine E.,
Stone Katie L.
Publication year - 2012
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/j.1532-5415.2012.03908.x
Subject(s) - epworth sleepiness scale , medicine , odds ratio , pittsburgh sleep quality index , actigraphy , confidence interval , depression (economics) , excessive daytime sleepiness , center for epidemiologic studies depression scale , geriatric depression scale , physical therapy , depressive symptoms , psychiatry , gerontology , sleep disorder , polysomnography , insomnia , sleep quality , anxiety , macroeconomics , economics , apnea
Objectives To examine the relationship between depressive symptoms and subjective and objective sleep in older women. Design Cross‐sectional. Setting Four U . S . clinical centers. Participants Three thousand forty‐five community‐dwelling women aged 70 and older. Measurements Depressive symptoms were assessed using the G eriatric D epression S cale, categorizing participants as normal (0–2, reference), some depressive symptoms (3–5), or depressed (≥6). Subjective sleep quality and daytime sleepiness were assessed using the P ittsburgh S leep Q uality I ndex ( PSQI ) and E pworth S leepiness S cale ( ESS ). Objective sleep measures were assessed using wrist actigraphy. Results In multivariable‐adjusted models, there were graded associations between greater level of depressive symptoms and worse subjective sleep quality and more subjective daytime sleepiness ( P ‐trends < .001). Women with some depressive symptoms (odds ratio ( OR ) = 1.82, 95% confidence interval ( CI ) = 1.48–2.24) and depressed ( OR = 2.84, 95% CI = 2.08–3.86) women had greater odds of reporting poor sleep ( PSQI >5). Women with some depressive symptoms ( OR = 1.97, 95% CI = 1.47–2.64) and depressed women ( OR = 1.70, 95% CI = 1.12–2.58) had greater odds of reporting excessive daytime sleepiness ( ESS >10). There were also graded associations between greater level of depressive symptoms and objectively measured wake after sleep onset ( WASO ) ( P ‐trend = .03) and wake episodes longer than 5 minutes ( P ‐trend = .006). Depressed women had modestly higher odds of WASO of 1 hour or longer ( OR = 1.37, 95% CI = 1.03–1.83). Women with some depressive symptoms ( OR = 1.49, 95% CI = 1.19–1.86) and depressed women ( OR = 2.04, 95% CI = 1.52–2.74) had greater odds of being in the highest quartile for number of nap episodes longer than 5 minutes. No associations between depressive symptom level and prolonged sleep latency, poor sleep efficiency, or short or long total sleep time were found. Conclusion Greater depressive symptom levels were associated with more subjective sleep disturbance and objective evidence of sleep fragmentation and napping.