Sleep timing, sleep regularity, and psychological health in early late life women: Findings from the Study of Women's Health Across the Nation (SWAN)

Leslie M Swanson; Michelle M Hood; Martica H Hall; Nancy E Avis; Hadine Joffe; Alicia Colvin; Kristine Ruppert; Howard M Kravitz; Genevieve Neal-Perry; Carol A Derby; Rachel Hess; Siobán D Harlow

doi:10.1016/j.sleh.2022.11.001

Sleep timing, sleep regularity, and psychological health in early late life women: Findings from the Study of Women's Health Across the Nation (SWAN)

Sleep Health. 2023 Apr;9(2):203-210. doi: 10.1016/j.sleh.2022.11.001. Epub 2022 Dec 9.

Authors

Affiliations

¹ Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA. Electronic address: LMSwan@med.umich.edu.
² Department of Epidemiology, University of Michigan, Ann Arbor, Michigan, USA.
³ Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
⁴ Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.
⁵ Connors Center for Women's Health and Gender Biology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA; Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
⁶ Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
⁷ Department of Psychiatry and Behavioral Sciences and Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA.
⁸ Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina, USA.
⁹ The Saul R. Korey Department of Neurology, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA.
¹⁰ Department of Population Health Sciences, Department of Internal Medicine, University of Utah, Salt Lake City, Utah, USA.

Abstract

Objectives: To examine the associations of actigraphy-assessed sleep timing and regularity with psychological health in early late life women, whose circadian rhythms may be impacted by aging.

Design: Cross-sectional.

Participants: A racially/ethnically diverse sample of 1197 community-dwelling women (mean age 65 years) enrolled in the Study of Women's Health Across the Nation.

Measures: Actigraphy-assessed sleep measures included timing (mean midpoint from sleep onset to wake-up) and regularity (standard deviation of midpoint in hours). Psychological health measures included a composite well-being score, the Center for Epidemiological Studies Depression Scale, and the Generalized Anxiety Disorder-7 Scale. Linear and logistic regression models, adjusted for covariates (including sleep duration), tested associations between sleep and psychological health measures.

Results: After covariate adjustment, a sleep midpoint outside of 2:00-4: 00 AM was significantly associated with depressive symptoms (β = 0.88, 95% CI = 0.06, 1.70) and scoring above the cut-point for clinically significant depressive symptoms (OR = 1.72, 95% CI = 1.15, 2.57). Sleep irregularity was significantly associated with lower psychological well-being (β = -0.18, 95% CI = -0.33, -0.03), depressive (β = 1.36, 95% CI = 0.29, 2.44) and anxiety (β = 0.93, 95% CI = 0.40, 1.46) symptoms, and scoring above the cut-point for clinically significant depressive (OR = 1.68, 95% CI = 1.01, 2.79) and anxiety (OR = 1.62, 95% CI = 1.07, 2.43) symptoms.

Conclusion: Above and beyond sleep duration, a sleep midpoint outside of 2:00-4:00 AM was associated with depressive symptoms while sleep irregularity was associated with multiple psychological health domains in late life women.

Keywords: Actigraphy; Anxiety; Older adults; Psychological health; Sleep regularity; Sleep timing; Well-being; Women; depression.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Actigraphy
Aged
Circadian Rhythm
Cross-Sectional Studies
Female
Humans
Sleep*
Women's Health*

Abstract

Publication types

MeSH terms

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