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.
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.
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.
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.
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.
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Vespa J. The graying of America: more older adults than kids by 2035. https://www.census.gov/library/stories/2018/03/graying-america.html; 2018. accessed 1/13/2022.
- Persistent psychological well-being predicts improved self-rated health over 9-10 years: longitudinal evidence from MIDUS.Health Psychol Open. 2015; 2: 1-11
- Enjoyment of life and declining physical function at older ages: a longitudinal cohort study.Cmaj. 2014; 186: E150-E156
- Well-being and chronic disease incidence: the English Longitudinal Study of Ageing.Psychosom Med. 2016; 78: 335-344
- Relationship between depression and frailty in older adults: a systematic review and meta-analysis.Ageing Res Rev. 2017; 36: 78-87
- Comparing anxiety and depression to obesity and smoking as predictors of major medical illnesses and somatic symptoms.Health Psychol. 2019; 38: 172-181
- Associations between depression and all-cause and cause-specific risk of death: a retrospective cohort study in the Veterans Health Administration.J Psychosom Res. 2015; 78: 324-331
- Midlife factors related to psychological well-being at an older age: Study of Women’s Health Across the Nation.J Womens Health (Larchmt). 2020; 30: 332-340
- Patterns of depressive disorders across 13 years and their determinants among midlife women: SWAN mental health study.J Affect Disord. 2016; 206: 31-40
- Psychosocial and health-related risk factors for depressive symptom trajectories among midlife women over 15 years: Study of Women's Health Across the Nation (SWAN).Psychol Med. 2019; 49: 250-259
- Positive affect, psychological well-being, and good sleep.J Psychosom Res. 2008; 64: 409-415
- Insomnia symptoms and well-being: longitudinal follow-up.Health Psychol. 2013; 32: 311-319
- Association of chronic insomnia symptoms and recurrent extreme sleep duration over 10 years with well-being in older adults: a cohort study.BMJ Open. 2016; 6e009501
- Cooccurrence and bidirectional prediction of sleep disturbances and depression in older adults: meta-analysis and systematic review.Neurosci Biobehav Rev. 2017; 75: 257-273
- Is insomnia a perpetuating factor for late-life depression in the IMPACT cohort?.Sleep. 2008; 31: 481-488
- Sleep problems, short sleep and a combination of both increase the risk of depressive symptoms in older people: a 6-year follow-up investigation from the English Longitudinal Study of Ageing.Sleep Med. 2017; 37: 60-65
- Anxiety symptoms and objectively measured sleep quality in older women.Am J Geriatr Psychiatry. 2009; 17: 136-143
- Beyond the mean: A systematic review on the correlates of daily intraindividual variability of sleep/wake patterns.Sleep Med Rev. 2016; 28: 108-124
- Sleep timing, sleep consistency, and health in adults: a systematic review.Appl Physiol Nutr Metab. 2020; 45: S232-s247
- Association of sleep-wake habits in older people with changes in output of circadian pacemaker.Lancet. 1992; 340: 933-936
- Night-to-night sleep variability in older adults with and without chronic insomnia.Sleep Med. 2010; 11: 56-64
- Sleep duration and timing are nonlinearly associated with depressive symptoms among older adults.Sleep Med. 2021; 81: 93-97
- An aggregate measure of sleep health is associated with prevalent and incident clinically significant depression symptoms among community-dwelling older women.Sleep. 2017; 40 (zsw075)
- Irregular sleep-wake patterns in older adults with current or remitted depression.J Affect Disord. 2020; 281: 431-437
- Multidimensional sleep health is not cross-sectionally or longitudinally associated with adiposity in the Study of Women's Health Across the Nation (SWAN).Sleep Health. 2020; 6: 790-796
- Longitudinal association between depressive symptoms and multidimensional sleep health: the SWAN Sleep Study.Ann Behav Med. 2021; 55: 641-652
- Epidemiology of the human circadian clock.Sleep Med Rev. 2007; 11: 429-438
- Season of birth, gender, and social-cultural effects on sleep timing preferences in humans.Sleep. 2009; 32: 423-426
- Validation of the sleep regularity index in older adults and associations with cardiometabolic risk.Sci Rep. 2018; 8: 14158
- Disagreement between subjective and actigraphic measures of sleep duration in a population-based study of elderly persons*.J Sleep Res. 2008; 17: 295-302
- SWAN: a multicenter, multiethnic, community-based cohort study of women and the menopausal transition.in: Lobo R Marcus R Kelsey J Menopause: Biology and Pathobiology. Academic Press, San Diego, CA2000: 175-188
- Racial/ethnic disparities in women’s sleep duration, continuity, and quality, and their statistical mediators: Study of Women’s Health Across the Nation.Sleep. 2019; 42: 1-10
- The SBSM Guide to Actigraphy Monitoring: Clinical and Research Applications.Behav Sleep Med. 2015; 13: S4-S38
- Multidimensional sleep health domains in older men and women: an actigraphy factor analysis.Sleep. 2021; 44: 1-11
- The satisfaction with life scale.J Pers Assess. 1985; 49: 71-75
- Development and validation of brief measures of positive and negative affect: the PANAS scales.J Pers Soc Psychol. 1988; 54: 1063-1070
- The structure of psychological well-being revisited.J Pers Soc Psychol. 1995; 69: 719-727
- The CES-D s self-report depression scale for research in the general population.Appl Psychol Measur. 1977; 1: 385-401
- A brief measure for assessing generalized anxiety disorder: the GAD-7.Arch Intern Med. 2006; 166: 1092-1097
- Assessing generalized anxiety disorder in elderly people using the GAD-7 and GAD-2 scales: results of a validation study.Am J Geriatr Psychiatry. 2014; 22: 1029-1038
- Race and financial strain are independent correlates of sleep in midlife women: the SWAN sleep study.Sleep. 2009; 32: 73-82
- Integrated Development for R [computer program].RStudio, Inc., Boston, MA2015
- Normal polysomnography parameters in healthy adults: a systematic review and meta-analysis.Lancet Respir Med. 2019; 7: 533-543
- Circadian type and bed-timing regularity in 654 retired seniors: correlations with subjective sleep measures.Sleep. 2011; 34: 235-239
- Sleep schedule regularity is associated with sleep duration in older australian adults: implications for improving the sleep health and wellbeing of our aging population.Clin Gerontol. 2018; 41: 113-122
- Sleep self-report and actigraphy measures in healthy midlife women: validity of the Pittsburgh Sleep Quality Index.J Womens Health (Larchmt). 2022; 31: 965-973
- The human circadian clock's seasonal adjustment is disrupted by daylight saving time.Curr Biol. 2007; 17: 1996-2000
- Circadian rhythm disruption and mental health.Transl Psychiatry. 2020; 10: 28
- Differences in sleep timing and related effects between African Americans and non-Hispanic Whites.J Clin Sleep Med. 2021; 17: 897-908
- Comparing polysomnography, actigraphy, and sleep diary in the home environment: the Study of Women’s Health Across the Nation Sleep Study.SLEEP Adv. 2022; 3: 1-12
Published online: December 09, 2022
Accepted: November 1, 2022
Received in revised form: October 31, 2022
Received: June 6, 2022
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