Subjective and Objective Sleep Disturbance and Longitudinal Risk of Depression in a Cohort of Older Women
Subjective and Objective Sleep Disturbance and Longitudinal Risk of Depression in a Cohort of Older Women
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DOI：
10.5665/sleep.3834
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发表时间：
2014-07-01
期刊：
影响因子：
5.6
通讯作者：
Stone, Katie L.
中科院分区：
文献类型：
--
作者：
Maglione, Jeanne E.;Ancoli-Israel, Sonia;Stone, Katie L.
目的：研究主观和客观睡眠障碍与抑郁症状之间的纵向关系。设计：纵向。设置：三个美国临床中心。参与者：952名社区居住的老年妇女（70岁或以上）。测量：在基线时，主观睡眠质量采用匹兹堡睡眠质量指数（PSQI）进行评估，客观睡眠测量采用腕动计进行评估。在基线和大约5年后，使用老年抑郁量表（GDS）评估抑郁症状。该分析仅限于基线时抑郁症状较少（GDS 0-2）的女性。PSQI评分越高，（根据标准差增加，表明主观睡眠质量更差）和抑郁症状恶化的几率更大（GDS增加>= 2分）（多变量比值比[莫尔] 1.19，置信区间[CI] 1.01-1.40，P = 0.036）。PSQI子量表中睡眠质量（莫尔比1.41，可信区间1.13-1.77，P < 0.003）和睡眠潜伏期（莫尔比1.21，可信区间1.03-1.41，P = 0.018）得分越高，抑郁症状恶化的可能性越大。客观评估显示基线睡眠后觉醒时间延长（WASO >= 60 min）与随访时抑郁症状恶化相关（莫尔比1.36，CI 1.01-1.84，P = 0.046）。其他客观评估的睡眠措施和恶化的抑郁症状之间没有关联。结论：在基线时很少或没有抑郁症状的老年妇女中，那些更主观地报告睡眠障碍和更客观地评估基线时的睡眠片段有更大的几率5年后抑郁症状恶化。未来的研究更详细地调查这种关系表示。
Objective: To investigate the longitudinal relationship between subjective and objective sleep disturbance and depressive symptoms.Design: Longitudinal.Setting: Three US clinical centers.Participants: Nine hundred fifty-two community-dwelling older women (70 y or older).Measurements: At baseline, subjective sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) and objective sleep measures were assessed with wrist actigraphy. Depressive symptoms were assessed with the Geriatric Depression Scale (GDS) at baseline and approximately 5 y later. The analysis was restricted to women with few (GDS 0-2) depressive symptoms at baseline.Results: There was an independent association between greater PSQI score (per standard deviation increase, indicating worse subjective sleep quality) at baseline and greater odds of worsening depressive symptoms (>= 2-point increase in GDS) (Multivariate Odds Ratio [MOR] 1.19, confidence interval [CI] 1.01-1.40, P = 0.036). Higher scores specifically on the sleep quality (MOR 1.41, CI 1.13-1.77, P < 0.003) and sleep latency (MOR 1.21, CI 1.03-1.41, P = 0.018) PSQI subscales were also associated with greater odds for worsening depressive symptoms. Objective assessments revealed an association between baseline prolonged wake after sleep onset (WASO >= 60 min) and worsening depressive symptoms at follow-up (MOR 1.36, CI 1.01-1.84, P = 0.046). There were no associations between other objectively assessed sleep measures and worsening depressive symptoms.Conclusions: In older women with few or no depressive symptoms at baseline, those with more subjectively reported sleep disturbance and more objectively assessed fragmentation of sleep at baseline had greater odds of worsening depressive symptoms 5 y later. Future studies investigating this relationship in more detail are indicated.