Longitudinal Association Between Sleep Duration and Depressive Symptoms in Chinese Elderly
Authors Jing R, Xu T, Rong H, Lai X, Fang H
Received 30 June 2020
Accepted for publication 14 September 2020
Published 13 October 2020 Volume 2020:12 Pages 737—747
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Steven A Shea
Rize Jing,1,2 Tingting Xu,1,3 Hongguo Rong,2 Xiaozhen Lai,1 Hai Fang2,4,5
1School of Public Health, Peking University, Beijing 100083, People’s Republic of China; 2China Center for Health Development Studies, Peking University, Beijing 100083, People’s Republic of China; 3Department of Social and Behavioral Science, Harvard TH Chan School of Public Health, Harvard University, Boston, Massachusetts 02115, USA; 4Peking University Health Science Center- Chinese Center for Disease Control and Prevention Joint Center for Vaccine Economics, Peking University, Beijing 100083, People’s Republic of China; 5Key Laboratory of Reproductive Health, National Health Commission of the People’s Republic of China, Peking University, Beijing 10083, People’s Republic of China
Correspondence: Hai Fang
China Center for Health Development Studies, Peking University, Xueyuan Road 38, Mailbox 505, Haidian District, Beijing 100083, People’s Republic of China
Aim: This study aimed to evaluate the longitudinal association between sleep duration and depressive symptoms among the elderly in China.
Methods: A data set from China Health and Retirement Longitudinal Study (CHARLS) in 2011, 2013 and 2015 was adopted with a total of 22,847 respondents aged ≥ 60-years-old. A linear regression analysis with generalized estimating equations was employed to examine the longitudinal associations between duration of total sleep, nighttime sleep and daytime nap, and depressive symptoms.
Results: An extra hour of total sleep including nighttime sleep and daytime nap was associated with lower incidence of depressive symptoms among the elderly after adjusting all confounders (OR=0.83, 95% CI: 0.82– 0.84). In addition, an extra hour of nighttime sleep (OR=0.82, 95% CI: 0.80– 0.83) or daytime nap (OR=0.93, 95% CI: 0.89– 0.97) was also negatively associated with depressive symptoms among the elderly. After controlling the total sleep time, an extra hour of nighttime sleep was negatively associated with depressive symptoms (OR=0.88, 95% CI: 0.84 to 0.92), while an extra hour of daytime nap displayed a positive association with depressive symptoms (OR=0.88, 95% CI: 0.84 to 0.92). Compared with the moderate nappers, only extended nappers had significantly higher incidence of depressive symptoms (OR=1.32, 95% CI: 1.19 to 1.45).
Conclusion: For the elderly in China, increasing their total sleep, nighttime sleep, and/or daytime nap duration would reduce the incidence of depressive symptoms. Moreover, after fixing the total sleep time, increasing nighttime sleep was more beneficial to the decrease of the incidence of depressive symptoms than daytime nap.
Keywords: sleep duration, daytime nap, depressive symptoms, China, the elderly
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