Bolstad Courtney J, Nadorff Michael R
Mississippi State University, Mississippi State, USA.
Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USA.
Heliyon. 2020 Nov 2;6(11):e05315. doi: 10.1016/j.heliyon.2020.e05315. eCollection 2020 Nov.
Symptoms of insomnia are associated with symptoms of depression and anxiety in older adults, yet less is known about the relation of specific forms of insomnia (i.e., onset, maintenance, and terminal insomnia) with these symptoms. This study explored how insomnia types related to symptoms of anxiety and depression in older adults. It was hypothesized that onset and maintenance insomnia would have stronger relations to anxiety and depressive symptoms than terminal insomnia.
One-hundred thirty-three older adults (mean age 69, age range 65-89) were recruited using Amazon's Mechanical Turk. Participants completed the Insomnia Severity Index, Geriatric Depression Scale-Short Form, and Geriatric Anxiety Inventory-Short Form.
Regression analyses that controlled for the comorbidity between anxiety and depressive symptoms indicated that onset insomnia was the only independent predictor of anxiety symptoms, and maintenance insomnia was the only independent predictor of depressive symptoms, each of which had medium to large effect sizes.
Our findings are limited by an online, primarily Caucasian, and non-clinical sample as well as the cross-sectional design of the study.
Our findings suggest that despite overlap between symptoms of depression and anxiety, insomnia may have different mechanisms of affecting each disorder. Thus, the type of insomnia is clinically relevant and should be assessed when symptoms of anxiety, depression, and/or sleep difficulties are reported.
失眠症状与老年人的抑郁和焦虑症状相关，但对于特定形式的失眠（即起始失眠、维持失眠和终末失眠）与这些症状之间的关系了解较少。本研究探讨了失眠类型与老年人焦虑和抑郁症状之间的关系。研究假设起始失眠和维持失眠与焦虑和抑郁症状的关系比终末失眠更强。
通过亚马逊的Mechanical Turk招募了133名老年人（平均年龄69岁，年龄范围65 - 89岁）。参与者完成了失眠严重程度指数、老年抑郁量表简版和老年焦虑量表简版。
控制焦虑和抑郁症状共病情况的回归分析表明，起始失眠是焦虑症状的唯一独立预测因素，维持失眠是抑郁症状的唯一独立预测因素，二者的效应量均为中等至较大。
我们的研究结果受到在线样本、主要为白种人且非临床样本以及研究的横断面设计的限制。
我们的研究结果表明，尽管抑郁和焦虑症状存在重叠，但失眠可能对每种障碍有不同的影响机制。因此，失眠类型具有临床相关性，当报告焦虑、抑郁和/或睡眠困难症状时应进行评估。
