Background Depressive symptoms and sleep disturbances disproportionately affect midlife women. While there may be a bidirectional association, few studies have examined whether depressive symptoms are longitudinally associated with subsequent sleep. Sleep is typically considered unidimensional, despite emerging evidence that multidimensional sleep health provides novel information on the sleep–health link. Purpose The current study examined whether higher depressive symptoms were longitudinally associated with poorer multidimensional sleep health. Method Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression Scale across six to nine annual assessments in 302 midlife women from the Study of Women’s Health Across the Nation. Six months after their last assessment, actigraphy (mean ± standard deviation = 29.3 ± 6.9 days) and self-report were used to assess sleep health components: efficiency, duration, mid-sleep timing, regularity, alertness, and satisfaction, which were dichotomized and summed to create a composite multidimensional sleep health score. Mixed-effects models were used to evaluate the longitudinal associations between depressive symptoms and multidimensional sleep health, as well as individual sleep health components, adjusting for covariates. Exploratory analyses stratified models by race/ethnicity. Results Higher depressive symptoms were associated with subsequent poorer multidimensional sleep health (p < .0.001) and lower alertness (p < .0001) and satisfaction with sleep (p < .0001). Conclusions Our finding that higher average depressive symptoms were associated longitudinally with actigraphy-measured poorer sleep health in midlife women is novel and converges with the larger body of evidence that these two common symptoms are strongly associated. The bidirectional relationship between these two prevalent symptoms needs to be studied in prospective longitudinal studies.

中文翻译：

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抑郁症状与多维睡眠健康之间的纵向关联：SWAN 睡眠研究

背景 抑郁症状和睡眠障碍不成比例地影响中年妇女。虽然可能存在双向关联，但很少有研究检查抑郁症状是否与随后的睡眠纵向相关。睡眠通常被认为是一维的，尽管新的证据表明多维睡眠健康提供了关于睡眠-健康联系的新信息。目的 目前的研究检查了较高的抑郁症状是否与较差的多维睡眠健康纵向相关。方法 使用流行病学研究中心抑郁量表对来自全国妇女健康研究的 302 名中年妇女进行六到九次年度评估，评估抑郁症状。最后一次评估后六个月，活动记录（平均值±标准偏差= 29.3±6。9 天）和自我报告用于评估睡眠健康成分：效率、持续时间、睡眠中期时间、规律性、警觉性和满意度，这些成分被二分法和总和以创建一个综合的多维睡眠健康评分。混合效应模型用于评估抑郁症状与多维睡眠健康以及个体睡眠健康成分之间的纵向关联，并调整协变量。探索性分析按种族/民族分层的模型。结果 较高的抑郁症状与随后较差的多维睡眠健康（p < .0.001）和较低的警觉性（p < .0001）和对睡眠的满意度（p < .0001）相关。结论 我们发现较高的平均抑郁症状与中年女性的活动记录仪测量的较差的睡眠健康纵向相关，这一发现是新颖的，并且与这两种常见症状密切相关的大量证据相一致。这两种普遍症状之间的双向关系需要在前瞻性纵向研究中进行研究。