Institute of Public Health, National Yang-Ming University, Taipei, Taiwan.
Department of Psychiatry, Shin-Kong Wu Ho-Su Memorial Hospital, Taipei, Taiwan.
Aging Ment Health. 2020 May;24(5):717-724. doi: 10.1080/13607863.2019.1582006. Epub 2019 Mar 5.
Given the close relationship between sleep-wake disturbances and depression, an in-depth investigation of such a relationship is imperative. The present study aims at elucidating the relationship between various sleep-wake disturbances and depression in older adults and at examining the influence of co-occurring anxiety on such associations. A community-based survey using the cohort from the Yilan Study in Taiwan was conducted from August 2013 to November 2016. Adults aged 65 and older were randomly selected to participate in the study. The Hospital Depression and Anxiety Scale was used to measure clinical depressive and anxiety symptoms. Insomnia and daytime sleepiness were defined through the Athens Insomnia Scale and the Epworth Sleepiness Scale, respectively. Furthermore, the use of hypnotics, subjective sleep duration and sleep-wake scheduling were evaluated. Their relationship with depression was examined through logistic regression analyses. There were 2620 participants surveyed and 247 (9.4%) had depression. Before controlling for anxiety, insomnia (OR: 1.78, 95% CI: 1.23-2.55), daytime sleepiness (OR: 1.79, 95% CI: 1.27-2.53), and long sleepers (OR: 1.77, 95% CI: 1.24-2.53) have a higher likelihood for depression in the multivariable regression analysis. However, when including anxiety into the multivariable regression model, only those with daytime sleepiness and long sleepers had an elevated risk for depression. Therefore, the association between insomnia and depression turned to be statistically non-significant. In older adults, various sleep-wake disturbances differ in their relationship with depression. In addition, daytime sleepiness and long sleep duration were mostly characteristic of depression when co-occurring anxiety was considered.
鉴于睡眠-觉醒障碍与抑郁之间的密切关系，深入研究这种关系至关重要。本研究旨在阐明老年人各种睡眠-觉醒障碍与抑郁之间的关系，并探讨共病焦虑对这些关联的影响。本研究采用台湾宜兰研究的队列进行了一项基于社区的调查，调查时间为 2013 年 8 月至 2016 年 11 月。随机选择 65 岁及以上的成年人参加研究。使用医院抑郁和焦虑量表测量临床抑郁和焦虑症状。通过雅典失眠量表和 Epworth 嗜睡量表分别定义失眠和白天嗜睡。此外，评估了催眠药物的使用、主观睡眠时间和睡眠-觉醒时间表。通过逻辑回归分析检查它们与抑郁的关系。共调查了 2620 名参与者，其中 247 人（9.4%）患有抑郁症。在未控制焦虑的情况下，失眠（OR：1.78，95%CI：1.23-2.55）、白天嗜睡（OR：1.79，95%CI：1.27-2.53）和长睡眠者（OR：1.77，95%CI：1.24-2.53）在多变量回归分析中更有可能患有抑郁症。然而，当将焦虑纳入多变量回归模型时，只有白天嗜睡和长睡眠者患抑郁症的风险增加。因此，失眠与抑郁之间的关联在统计学上变得不显著。在老年人中，各种睡眠-觉醒障碍与抑郁的关系不同。此外，当考虑共病焦虑时，白天嗜睡和长睡眠时间大多是抑郁的特征。
