Influence of sleep status on depression and anxiety onset among Chinese elderly people based on CLHLS data
Objective To investigate the impact of sleep status on depression and anxiety in elderly Chinese individuals,so as to provide a basis for the prevention of these conditions.Methods Health survey data were collected from Peking U-niversity's"China Elderly Health and Family Happiness Survey(CLHLS)"in 2011 and 2018.The depressive status of the elderly was assessed using the Center for Epidemiologic Studies Depression Scale-10(CES-D10),and anxiety status was e-valuated using the Generalized Anxiety Disorder scale-7(GAD-7).Covariance analysis was used to compare differences in depression and anxiety scores between groups with different variations in sleep duration or quality,and a multivariate lo-gistic regression model was used to analyze the influence of changes in sleep duration or quality on depression and anxiety among the elderly.Results A total of 1 387 elderly people aged ≥65 years were included,with a mean sleep duration of 7.46 hours,9.88％of participants reported poor sleep quality,and 30.21％suffered from sleep deprivation.After adjus-ting for gender,age,education level,marital status,insurance status,annual household income,smoking status,alcohol con-sumption,and exercise habits,the CES-D10 scores were higher in the poor and average sleep quality groups compared to the good sleep quality group(F=18.67).The group with less than 7 hours of sleep had higher CES-D10 scores than those with 7-9 hours(F=100.62).Groups with persistent poor sleep,deteriorating sleep,and improved sleep all had higher CES-D10 scores than those with consistently good sleep(F=9.47).Additionally,those with consistently insuffi-cient or reduced sleep duration had higher CES-D10 scores than those with consistently sufficient sleep(F=28.84).All these differences were statistically significant(P＜0.05).Adjusting for potential confounders,GAD-7 scores were higher in the poor sleep quality group than the good sleep quality group(F=11.75).Scores were also higher in those sleeping less than 7 hours compared to those sleeping 7-9 hours(F=19.46).Groups with persistent poor sleep or deteriorating sleep had higher scores than those with consistently good sleep(F=5.45).Those with consistently insufficient sleep had higher scores than those with consistently sufficient sleep(F=7.51).All these differences were statistically significant(P＜0.05).Individuals who experienced improvement in sleep quality had the lowest risk of depression and anxiety(de-pression OR=1.65,95％CI:1.17-2.33,P＜0.05;anxiety OR=1.92,95％CI:1.01-3.69,P＜0.05),while those with deterioration(depression OR=5.20,95％CI:3.90-6.93,P＜0.05;anxiety OR=2.80,95％CI:1.67-4.69,P＜0.05),and those with persistent poor sleep(depression OR=5.13,95％CI:3.74-7.05,P＜0.05;anxiety OR=4.07,95％CI:2.42-6.84,P＜0.05)had a significantly increased risk of depression and anxiety.Similarly,those with increased sleep du-ration had the lowest risk of depression and anxiety(depression OR=1.26,95％CI:0.91-1.75,P＜0.05;anxiety OR=1.36,95％CI:0.76-2.38,P＜0.05)and those with consistently insufficient sleep duration(depressionOR=2.46,95％CI:1.80-3.36,P＜0.05;anxiety OR=2.26,95％CI:1.42-3.60,P＜0.05)had a significantly increased risk of depres-sion and anxiety.Conclusion Short sleep duration and poor sleep quality are associated with an increased risk of depres-sion and anxiety among elderly individuals,while those with increased sleep duration and improved sleep quality have a lower risk of developing these conditions.
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