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

J Am Geriatr Soc. 2008 Jul;56(7):1228-35. doi: 10.1111/j.1532-5415.2008.01753.x. Epub 2008 May 14.


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.

Publication types

  • Multicenter Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antidepressive Agents / therapeutic use
  • Depression / classification
  • Depression / complications*
  • Depression / drug therapy
  • Geriatric Assessment / methods*
  • Health Status
  • Humans
  • Male
  • Prevalence
  • Sleep Wake Disorders / etiology*
  • Sleep*
  • United States / epidemiology


  • Antidepressive Agents