Association between depressive symptoms and sleep disturbances in community-dwelling older men

Misti L. Paudel, Brent C. Taylor, Susan J. Diem, Katie L. Stone, Sonia Ancoli-Israel, Susan Redline, Kristine E. Ensrud

Research output: Contribution to journalArticlepeer-review

121 Scopus citations


OBJECTIVES: To examine the association between depressive symptoms and subjective and objective measures of sleep in community-dwelling older men. DESIGN: Cross-sectional. SETTING: Six U.S. clinical centers. PARTICIPANTS: Three thousand fifty-one men aged 67 and older. MEASUREMENTS: 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. CONCLUSION: 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.

Original languageEnglish (US)
Pages (from-to)1228-1235
Number of pages8
JournalJournal of the American Geriatrics Society
Issue number7
StatePublished - Jul 2008


  • Actigraphy
  • Depression
  • Depressive symptoms
  • Elderly
  • Sleep


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