Sleep Disturbances and Risk of Depression in Older Men

Overview

Journal Sleep

Publisher Oxford University Press

Specialty Psychiatry

Date 2013 Jul 2

PMID 23814340

Citations 39

Authors

Misti Paudel

Brent C Taylor

Sonia Ancoli-Israel

Terri Blackwell

Jeanne E Maglione

Katie Stone

Susan Redline

Kristine E Ensrud

Affiliations

Soon will be listed here.

Abstract

Introduction: Self-reported sleep disturbances are associated with an increased risk of depression in younger and older adults, but associations between objective assessments of sleep/wake disturbances via wrist actigraphy and risk of depression are unknown.

Methods: Depressive symptoms (Geriatric Depression Scale [GDS]), self-reported (questionnaires), and objective (actigraphy) sleep parameters were measured at baseline in 2,510 nondepressed men 67 y or older. Depressive symptoms were reassessed an average of 3.4 ± 0.5 y later.

Results: Of the 2,510 men without evidence of depression at baseline, 116 (4.6%) were depressed (GDS ≥ 6) at the follow-up examination. After adjusting for multiple potential confounders, including baseline depressive symptoms (GDS 0-5), there was evidence of an association between poor self-reported sleep quality and higher odds of being depressed at follow-up (multivariable odds ratio [MOR] = 1.53, 95% confidence interval (CI) 1.00-2.33). In age- and site-adjusted models, objectively measured reduced sleep efficiency (odds ratio [OR] = 1.88, 95% CI 1.13-3.13), prolonged sleep latency (OR = 1.77, 95% CI 1.04-3.00), greater nighttime wakefulness (OR = 1.48, 95% CI 1.01-2.18) and multiple long-wake episodes (OR = 1.69, 95% CI 1.15-2.47) were associated with increased odds of depression at follow-up, but these associations were attenuated and no longer significant after further adjustment for number of depressive symptoms at baseline. Self-reported excessive daytime sleepiness and objectively measured total sleep time were not associated with depression status at follow-up. Excluding baseline antidepressant users from the analyses did not alter the results.

Conclusions: Among nondepressed older men, poor self-reported sleep quality was associated with increased odds of depression several years later. Associations between objectively measured sleep disturbances (e.g., reduced sleep efficiency, prolonged sleep latency, greater nighttime wakefulness, and greater long-wake episodes) and depression several years later were largely explained by a greater burden of depressive symptoms at baseline.

Citation: Paudel M; Taylor BC; Ancoli-Israel S; Blackwell T; Maglione JE; Stone K; Redline S; Ensrud KE; for the Osteoporotic Fractures in Men Study Group. Sleep disturbances and risk of depression in older men. 2013;36(7):1033-1040.

Citing Articles

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Depressive symptom screening in elderly by passive sensing data of smartphones or smartwatches: A systematic review.

Adhibai R, Kosiyaporn H, Markchang K, Nasueb S, Waleewong O, Suphanchaimat R PLoS One. 2024; 19(6):e0304845.

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Hou Z, Chen Y, Sun Y, Song C, Deng H, Cheng N Nat Sci Sleep. 2023; 15:1079-1091.

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References

Yokoyama E, Kaneita Y, Saito Y, Uchiyama M, Matsuzaki Y, Tamaki T . Association between depression and insomnia subtypes: a longitudinal study on the elderly in Japan. Sleep. 2010; 33(12):1693-702. PMC: 2982740. DOI: 10.1093/sleep/33.12.1693. View

Blank J, Cawthon P, Carrion-Petersen M, Harper L, Johnson J, Mitson E . Overview of recruitment for the osteoporotic fractures in men study (MrOS). Contemp Clin Trials. 2005; 26(5):557-68. DOI: 10.1016/j.cct.2005.05.005. View

Callahan C, Kroenke K, Counsell S, Hendrie H, Perkins A, Katon W . Treatment of depression improves physical functioning in older adults. J Am Geriatr Soc. 2005; 53(3):367-73. DOI: 10.1111/j.1532-5415.2005.53151.x. View

Ensrud K, Blackwell T, Ancoli-Israel S, Redline S, Cawthon P, Paudel M . Sleep disturbances and risk of frailty and mortality in older men. Sleep Med. 2012; 13(10):1217-25. PMC: 3449012. DOI: 10.1016/j.sleep.2012.04.010. View

Fitti J, Kovar M . The Supplement on Aging to the 1984 National Health Interview Survey. Vital Health Stat 1. 1987; (21):1-115. View

Giles D, Kupfer D, Rush A, Roffwarg H . Controlled comparison of electrophysiological sleep in families of probands with unipolar depression. Am J Psychiatry. 1998; 155(2):192-9. DOI: 10.1176/ajp.155.2.192. View

Spira A, Beaudreau S, Stone K, Kezirian E, Lui L, Redline S . Reliability and validity of the Pittsburgh Sleep Quality Index and the Epworth Sleepiness Scale in older men. J Gerontol A Biol Sci Med Sci. 2011; 67(4):433-9. PMC: 3309871. DOI: 10.1093/gerona/glr172. View

Johns M . A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep. 1991; 14(6):540-5. DOI: 10.1093/sleep/14.6.540. View

Franzen P, Buysse D . Sleep disturbances and depression: risk relationships for subsequent depression and therapeutic implications. Dialogues Clin Neurosci. 2009; 10(4):473-81. PMC: 3108260. View

10.

Jean-Louis G, Kripke D, MASON W, Elliott J, Youngstedt S . Sleep estimation from wrist movement quantified by different actigraphic modalities. J Neurosci Methods. 2001; 105(2):185-91. DOI: 10.1016/s0165-0270(00)00364-2. View

11.

Spira A, Covinsky K, Rebok G, Punjabi N, Stone K, Hillier T . Poor sleep quality and functional decline in older women. J Am Geriatr Soc. 2012; 60(6):1092-8. PMC: 3375617. DOI: 10.1111/j.1532-5415.2012.03968.x. View

12.

Ancoli-Israel S . Sleep and aging: prevalence of disturbed sleep and treatment considerations in older adults. J Clin Psychiatry. 2005; 66 Suppl 9:24-30. View

13.

BARONE J, Roberts H . Caffeine consumption. Food Chem Toxicol. 1996; 34(1):119-29. DOI: 10.1016/0278-6915(95)00093-3. View

14.

Johns M . Sensitivity and specificity of the multiple sleep latency test (MSLT), the maintenance of wakefulness test and the epworth sleepiness scale: failure of the MSLT as a gold standard. J Sleep Res. 2000; 9(1):5-11. DOI: 10.1046/j.1365-2869.2000.00177.x. View

15.

Buysse D, Reynolds 3rd C, Monk T, BERMAN S, Kupfer D . The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989; 28(2):193-213. DOI: 10.1016/0165-1781(89)90047-4. View

16.

Ohayon M . Epidemiology of insomnia: what we know and what we still need to learn. Sleep Med Rev. 2003; 6(2):97-111. DOI: 10.1053/smrv.2002.0186. View

17.

Pahor M, Chrischilles E, Guralnik J, Brown S, Wallace R, Carbonin P . Drug data coding and analysis in epidemiologic studies. Eur J Epidemiol. 1994; 10(4):405-11. DOI: 10.1007/BF01719664. View

18.

Buysse D, Reynolds 3rd C, Monk T, Hoch C, Yeager A, Kupfer D . Quantification of subjective sleep quality in healthy elderly men and women using the Pittsburgh Sleep Quality Index (PSQI). Sleep. 1991; 14(4):331-8. View

19.

Livingston G, Blizard B, Mann A . Does sleep disturbance predict depression in elderly people? A study in inner London. Br J Gen Pract. 1993; 43(376):445-8. PMC: 1372481. View

20.

Fava M . Daytime sleepiness and insomnia as correlates of depression. J Clin Psychiatry. 2004; 65 Suppl 16:27-32. View