An Aggregate Measure of Sleep Health Is Associated With Prevalent and Incident Clinically Significant Depression Symptoms Among Community-Dwelling Older Women

Objectives: Sleep can be characterized along multiple dimensions. We investigated whether an aggregate measure of sleep health was associated with prevalent and incident clinically significant depression symptoms in a cohort of older women. Methods: Participants were older women (mean age 80.1 years) who completed baseline (n = 6485) and follow-up (n = 3806) visits, approximately 6 years apart, in the Study of Osteoporotic Fractures (SOF). Self- reported sleep over the past 12 months was categorized as good or poor across 5 dimensions: satisfaction with sleep duration, daytime sleepiness, mid-sleep time, sleep onset latency, and sleep duration. An aggregate measure of sleep health was calculated by summing the number of poor dimensions. Clinically significant depression symptoms were defined as a score = 6 on the Geriatric Depression Scale. Relationships between sleep health and depression symptoms were evaluated with multivariate logistic regression, adjusting for health measures and medications. Results: Individual sleep health dimensions of sleep satisfaction, daytime sleepiness, mid- sleep time, and sleep onset latency were significantly associated with prevalent depression symptoms (odds ratios [ OR] = 1.26- 2.69). Sleep satisfaction, daytime sleepiness, and sleep onset latency were significantly associated with incident depression symptoms (OR = 1.32-1.79). The number of poor sleep health dimensions was associated in a gradient fashion with greater odds of prevalent (OR = 1.62-5.41) and incident (OR = 1.47-3.15) depression symptoms. Conclusion: An aggregate, multidimensional measure of sleep health was associated with both prevalent and incident clinically- significant depression symptoms in a gradient fashion. Future studies are warranted to extend these findings in different populations and with different health outcomes.