Sleep Architecture and Mental Health Among Community-Dwelling Older Men

Abstract

Objectives: To investigate the association of mood and anxiety symptoms with sleep architecture (the distribution of sleep stages) in community-dwelling older men.

Method: We used in-home unattended polysomnography to measure sleep architecture in older men. Men were categorized into 4 mental health categories: (a) significant depressive symptoms only (DEP+ only, Geriatric Depression Scale ≥ 6), (b) significant anxiety symptoms only (ANX+ only, Goldberg Anxiety Scale ≥ 5), (c) significant depressive and anxiety symptoms (DEP+/ANX+), or (d) no significant depressive or anxiety symptoms (DEP-/ANX-).

Results: Compared with men without clinically significant symptomology, men with depressive symptoms spent a higher percentage of time in Stage 2 sleep (65.42% DEP+ only vs 62.47% DEP-/ANX-, p = .003) and a lower percentage of time in rapid eye movement sleep (17.05% DEP+ only vs 19.44% DEP-/ANX-, p = .0005). These differences persisted after adjustment for demographic/lifestyle characteristics, medical conditions, medications, and sleep disturbances, and after excluding participants using psychotropic medications. The sleep architecture of ANX+ or DEP+/ANX+ men did not differ from asymptomatic men.

Discussion: Depressed mood in older adults may be associated with accelerated age-related changes in sleep architecture. Longitudinal community-based studies using diagnostic measures are needed to further clarify relationships among common mental disorders, aging, and sleep.

Keywords: Aging; Anxiety; Depression; Epidemiology; Sleep architecture.