Subjective but Not Objective Sleep is Associated with Subsyndromal Anxiety and Depression in Community-Dwelling Older Adults

Gould, Christine E.; Karna, Rosy; Jordan, Joshua T.; Kawai, Makoto; Hirst, Rayna B; Hantke, Nathan; Pirog, Sophia; Cotto, Isabelle; Rose, Sophia Miryam Schüssler‐Fiorenza; Beaudreau, Sherry A.; O’Hara, Ruth

doi:10.1016/j.jagp.2018.03.010

Cited by 56 publications

(13 citation statements)

References 19 publications

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“…Similarly, the sleep, cognitive and inflammatory data presented in this study were assessed at one time-point, rather than specifically assessing the prior evening’s sleep and the following morning’s inflammatory markers. We used subjective sleep measures, which, although they may be subject to recall biases, have been reported in psychiatric populations to correlate significantly with objective sleep measures (73) and physical/mental health outcomes (59) as well as having clinical utility in diagnosing and treating sleep disorders (14, 74). Although we did not use a validated sleep questionnaire such as the Pittsburgh Sleep Quality Index, the measures did include key features of sleep that overlap with clinical definitions of insomnia.…”

Section: Discussionmentioning

confidence: 99%

Sleep Disturbances and Inflammatory Biomarkers in Schizophrenia: Focus on Sex Differences

Lee

Ancoli‐Israel

Eyler

et al. 2019

The American Journal of Geriatric Psychiatry

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Objectives: Persons with schizophrenia, and women in particular, are at high risk for sleep disturbances and inflammatory activation. The sleep-inflammation link has been reported to be stronger in women within the general population. This study sought to examine the sleep-inflammation link in persons with schizophrenia and its relationship with demographic, clinical and cognitive variables. Design: Cross-sectional case-control study. Participants: Community-dwelling outpatients with schizophrenia (N=144, 46% women) and non-psychiatric comparison (NC) participants (N=134, 52% women), age 26–65 years. Measurements: Reported sleep disturbances (sleep quality and duration), and mental and physical health were assessed. Cognitive assessments included executive functioning (Delis-Kaplan Executive Function System) and subjective cognitive complaints (Telephone Interview for Cognitive Status - modified.) Inflammatory biomarkers included pro-inflammatory cytokines [high sensitivity C-Reactive Protein (hs-CRP), Interleukin (IL)-6, Tumor Necrosis Factor-α (TNF-α)] and an anti-inflammatory cytokine (IL-10). Results: The schizophrenia group had longer sleep duration, worse sleep quality, and increased levels of hs-CRP, IL-6, and TNF-α compared to NCs. Women with schizophrenia were less likely to have good sleep quality and had elevated levels of hs-CRP and IL-6 compared to men with schizophrenia. In the schizophrenia group, worse sleep quality and cognitive complaints were associated with higher hs-CRP and IL-6 levels. Female sex and younger age were also associated with higher hs-CRP levels. Conclusions: Sleep disturbances and increased inflammation, which were common in schizophrenia, were associated in persons with schizophrenia. Moreover, women with schizophrenia had worse sleep quality and inflammation than men. Further examination of the sleep-inflammation links, their contribution to clinical outcomes, and sex-specific factors is warranted.

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Section: Discussionmentioning

confidence: 99%

Sleep Disturbances and Inflammatory Biomarkers in Schizophrenia: Focus on Sex Differences

Lee

Ancoli‐Israel

Eyler

et al. 2019

The American Journal of Geriatric Psychiatry

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“…No study has been su ciently large to show a statistically signi cant modifying effect of sleep quality and anxiety in an overall healthy population. However, there was another study found that poor sleep quality was associated with both depression and anxiety, whereas only daytime sleepiness was associated with anxiety symptoms in older adults [34].…”

Section: Discussionmentioning

confidence: 93%

Dose-response association of sleep quality with anxiety symptoms in Chinese rural population: the Henan Rural Cohort

Shen

Zhang

Wang

et al. 2020

Preprint

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Objectives The epidemiological evidence on the effect of sleep quality on anxiety symptoms has been inconclusive. This study aimed at exploring the relationship between sleep quality and anxiety symptoms in rural China and investigated whether age, lifestyle and chronic diseases modified the association. Methods A total of 27,911 participants aged 18–79 years from the Henan Rural Cohort Study were included in the study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Poor sleep quality was defined as PSQI ≥6. Anxiety symptoms were evaluated with the two-item generalized anxiety disorder scale (GAD-2). A score ≥6 was view as having anxiety symptoms. Logistic regression and restricted cubic spline was conducted to examine the association of sleep quality with anxiety symptoms. Results Altogether, 6,087(21.80%) were poor sleepers and 1,557(5.58%) had anxiety symptoms. The odds of anxiety were increased with increment of PSQI score after fitting restricted cubic splines. And the poor sleep qualitywas associated with a higher possibility of anxiety symptoms (4.60, 3.70-5.72) in men, and (3.56, 3.10-4.09) in women on multivariable analysis. Further stratified analyses showed that the effect of sleep quality and anxiety symptoms could be modified by age, marital status, smoking status, drinking status, hypertension andtype 2 diabetes mellitus. Conclusions A dose-response association between PSQI score and anxiety symptoms was found. In addition, relationship between poor sleep quality and anxiety symptoms was observed in this rural population, especially in participants aged ≥60 years and those with unhealthy habits or had a chronic disease.

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“…Few studies have been sufficiently large to show a statistically significant modifying effect of sleep quality and anxiety in an overall healthy population. However, another study found that poor sleep quality was associated with both depression and anxiety, whereas only daytime sleepiness was associated with anxiety symptoms in older adults [43].…”

Section: Discussionmentioning

confidence: 95%

Dose-response association of sleep quality with anxiety symptoms in Chinese rural population: the Henan rural cohort

et al. 2020

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Background: The epidemiological evidence on the association of sleep quality on anxiety symptoms has been inconclusive. This study aimed to explore the association between sleep quality and anxiety symptoms in rural Chinese population and investigate whether age, lifestyles, and chronic diseases modified this association. Methods: A total of 27,911 participants aged 18-79 years from the Henan Rural Cohort Study were included in the study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) scale. Poor sleep quality was defined as PSQI ≥6. Anxiety symptoms were evaluated with the two-item generalized anxiety disorder scale (GAD-2). Individual with score ≥ 3 was viewed as having anxiety symptoms. Logistic regression and restricted cubic spline were conducted to examine the association of sleep quality with anxiety symptoms. Results: Altogether, 6087 (21.80%) participants were poor sleepers and 1557 (5.58%) had anxiety symptoms. The odds of anxiety were increased with increment of PSQI score after fitting restricted cubic splines. The poor sleep quality was associated with a higher possibility of anxiety symptoms [odd ratio (OR): 4.60, 95% confidence interval (CI): 3.70-5.72] in men, and (OR: 3.56, 95% CI: 3.10-4.09) in women for multivariable analysis. Further, stratified analyses showed that the effect of sleep quality on anxiety symptoms could be modified by age, marital status, smoking status, drinking status, hypertension, and type 2 diabetes mellitus. Conclusions: A dose-response association between PSQI score and anxiety symptoms was found. In addition, the relationship between poor sleep quality and greater anxiety symptoms was observed in this rural population, especially in participants aged ≥60 years and those with unhealthy habits or had a chronic disease. Trial registration: The trial was prospectively registered on July 6, 2015 and available online at ClinicalTrials.gov ID: ChiCTR-OOC-15006699.

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Subjective but Not Objective Sleep is Associated with Subsyndromal Anxiety and Depression in Community-Dwelling Older Adults

Cited by 56 publications

References 19 publications

Sleep Disturbances and Inflammatory Biomarkers in Schizophrenia: Focus on Sex Differences

Sleep Disturbances and Inflammatory Biomarkers in Schizophrenia: Focus on Sex Differences

Dose-response association of sleep quality with anxiety symptoms in Chinese rural population: the Henan Rural Cohort

Dose-response association of sleep quality with anxiety symptoms in Chinese rural population: the Henan rural cohort

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