Depressive Symptoms and Subjective and Objective Sleep in Community-Dwelling Older Women
Article first published online: 16 MAR 2012
© 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society
Journal of the American Geriatrics Society
Volume 60, Issue 4, pages 635–643, April 2012
How to Cite
Maglione, J. E., Ancoli-Israel, S., Peters, K. W., Paudel, M. L., Yaffe, K., Ensrud, K. E. and Stone, K. L. (2012), Depressive Symptoms and Subjective and Objective Sleep in Community-Dwelling Older Women. Journal of the American Geriatrics Society, 60: 635–643. doi: 10.1111/j.1532-5415.2012.03908.x
- Issue published online: 11 APR 2012
- Article first published online: 16 MAR 2012
- NIH. Grant Number: R25MH7450
- Academic Geriatric Resource Center. Grant Numbers: 2 R01 AG027574–22A1, AG05407, AR35582, AG05394, AR35584, AR35583, AG026720, R01 MH086498, 09SD-A7–1-24, AG08415, AG05407, AR35582, AG05394, AR35584, AR35583, R01 AG005407, R01 AG027576–22, 2 R01 AG005394–22A1
To examine the relationship between depressive symptoms and subjective and objective sleep in older women.
Four U.S. clinical centers.
Three thousand forty-five community-dwelling women aged 70 and older.
Depressive symptoms were assessed using the Geriatric Depression Scale, 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 Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS). Objective sleep measures were assessed using wrist actigraphy.
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.
Greater depressive symptom levels were associated with more subjective sleep disturbance and objective evidence of sleep fragmentation and napping.