Abstract
BACKGROUND: The rural elderly in China have a high prevalence of depressive symptoms, which is closely linked to poor sleep quality. This not only poses significant threats to their physical and mental health but also lacks in-depth exploration of associations specific to different sleep dimensions. We hypothesize that specific sleep dimensions are independently and significantly associated with depressive symptoms in this population. AIM: To explore the links between different sleep dimensions and depressive symptoms among rural elderly in China. METHODS: This cross-sectional study enrolled 5136 older adults (≥ 60 years) recruited between April and June 2024. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index, and depressive symptoms were assessed with the Patient Health Questionnaire-9. Binary logistic regression analysis was employed to examine the associations between problems in different sleep dimensions and depressive symptoms among these older adults. RESULTS: The prevalence of depressive symptoms was 19.5%, and the overall rate of sleep disorders was 40.13%. Among the rural elderly, six sleep dimensions were found to be statistically significantly associated with depressive symptoms (all P < 0.05), with the following odds ratios (ORs) and 95% confidence intervals (CIs): Subjective sleep quality (OR = 2.066, 95%CI: 1.709-2.497), sleep onset latency (OR = 2.476, 95%CI: 2.062-2.972), sleep efficiency (OR = 1.686, 95%CI: 1.369-2.076), sleep disturbances (OR = 2.092, 95%CI: 1.566-2.795), daytime dysfunction (OR = 3.378, 95%CI: 2.882-3.959), and use of hypnotic medications (OR = 1.662, 95%CI: 1.093-2.525). CONCLUSION: Poor subjective sleep quality, prolonged sleep onset latency, reduced sleep efficiency, sleep disturbances, daytime dysfunction, and use of hypnotic medications are associated with depressive symptoms in the elderly. Therefore, healthcare professionals should target elderly individuals with sleep disorders and implement effective interventions to alleviate their depressive symptoms.