Department of Project Design and Statistics, West China Hospital, Sichuan University, Chengdu 610041, China.
Sichuan Provincial Center for Mental Health, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu 610072, China; Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu 610072, China.
J Affect Disord. 2022 Nov 15;317:185-192. doi: 10.1016/j.jad.2022.08.051. Epub 2022 Aug 24.
Quantifying the effect of depression on sleep duration is of great importance to the diagnosis, control, prevention of sleep-related diseases and understanding related biological mechanisms. However, existing studies explored the effect without considering depressive duration, which may cause inaccurate results.
Accessing the data from the China Health and Retirement Longitudinal Study in 2011, 2013, 2015 and 2018, we used the interval between two interviews with persistent depression status to approximate depressive duration. Five analysis subsamples with different depressive durations, i.e., 2, 3, 4, 5, 7 years, were obtained. The change amount of sleep duration between two interviews was used as the outcome variable. A multiple linear model was independently used to estimate the effect in each subsample, and meta-regression was used to test the trend. Subgroup analyses in terms of genders, ages and baseline sleep durations were performed.
On average, 2, 3, 4, 5, 7-years depressive durations significantly reduced sleep duration by 0.46, 0.57, 0.72, 0.75, 1.07 h (P < 0.001), respectively. Especially for the elderly, female, and participants with normal baseline sleep duration, the reduction was larger. Trend test showed that the variation trend was significant (P < 0.001). Similar results were found in the subgroup analyses.
Sleep duration and depression are not measured by gold-standard methods.
Depression significantly reduces sleep duration, especially for the elderly, female, and people with normal baseline sleep duration. Longer depressive duration reduces sleep duration more. Such finding provides more detailed epidemiological evidence for depression-sleep relationship.
定量评估抑郁对睡眠时长的影响对于疾病的诊断、控制、预防以及对相关生物学机制的理解至关重要。然而，现有的研究在评估影响时并未考虑抑郁持续时间，这可能导致结果不准确。
本研究利用中国健康与养老追踪调查 2011、2013、2015 和 2018 年的数据，采用两次出现持续性抑郁状态的间隔时间来近似抑郁持续时间。我们获得了五个具有不同抑郁持续时间的分析亚组，即 2、3、4、5、7 年。两次访谈之间睡眠时长的变化量被用作因变量。使用多元线性模型在每个亚组中独立估计影响，使用元回归检验趋势。并进行了性别、年龄和基线睡眠时长的亚组分析。
平均而言，2、3、4、5、7 年的抑郁持续时间分别显著减少 0.46、0.57、0.72、0.75、1.07 小时的睡眠时长（P<0.001）。对于老年人、女性和基线睡眠正常的参与者，这种减少更为明显。趋势检验显示这种变化趋势具有显著意义（P<0.001）。在亚组分析中也得到了类似的结果。
睡眠时长和抑郁不是用金标准方法测量的。
抑郁显著减少了睡眠时长，特别是对于老年人、女性和基线睡眠正常的人群。抑郁持续时间越长，睡眠时长减少越多。这一发现为抑郁与睡眠之间的关系提供了更详细的流行病学证据。
