残疾儿童主要照顾者中自我报告及客观测量的睡眠障碍与抑郁的关联。
Associations of self-reported and objectively measured sleep disturbances with depression among primary caregivers of children with disabilities.
作者信息
Orta Olivia R, Barbosa Clarita, Velez Juan Carlos, Gelaye Bizu, Chen Xiaoli, Stoner Lee, Williams Michelle A
机构信息
Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
Worker's Hospital, The Chilean Safety Association, Santiago, Chile.
出版信息
Nat Sci Sleep. 2016 Jun 10;8:181-8. doi: 10.2147/NSS.S104338. eCollection 2016.
OBJECTIVE
The objective of this study was to determine the association between sleep and depression using both self-reported (subjective) and actigraphic (objective) sleep traits.
METHODS
A cross-sectional study was conducted among 175 female primary caregivers of children with disabilities receiving care at a rehabilitation center in Punta Arenas, Chile. The eight-item Patient Health Questionnaire was used to ascertain participants' depression status. The Pittsburgh Sleep Quality Index was used to define subjective, or perceived, sleep quality. Wrist-worn actigraph monitors, worn for seven consecutive nights, were used to characterize objective sleep quality and disturbances. Interviewer-administered questionnaires were used to collect information on sociodemographic and lifestyle factors. Linear regression models were fit using continuous sleep parameters as the dependent variables and depression status as the independent variable. Multivariable models were adjusted for body mass index, marital status, smoking status, education level, and children's disabilities.
RESULTS
Using an eight-item Patient Health Questionnaire score ≥10, 26.3% of participants presented with depression. Depressed women were more likely to self-report overall poorer (subjective) sleep compared to non-depressed women; however, differences in sleep were not consistently noted using actigraphic (objective) sleep traits. Among the depressed, both sleep duration and total time in bed were significantly underestimated. In multivariable models, depression was negatively associated with sleep duration using both subjective (β=-0.71, standard error [SE] =0.25; P=0.006) and objective sleep (β=-0.42, SE =0.19; P=0.026).
CONCLUSION
The association between sleep and depression differed comparing subjective and objective methods of assessment. Research strategies allowing for the integration of both perceived and objective measures of sleep traits are encouraged.
目的
本研究的目的是使用自我报告（主观）和活动记录仪（客观）睡眠特征来确定睡眠与抑郁之间的关联。
方法
在智利蓬塔阿雷纳斯一家康复中心接受护理的175名残疾儿童的女性主要照料者中进行了一项横断面研究。使用八项患者健康问卷来确定参与者的抑郁状态。匹兹堡睡眠质量指数用于定义主观或感知的睡眠质量。连续佩戴七晚的腕部活动记录仪用于表征客观睡眠质量和干扰情况。由访谈员管理的问卷用于收集社会人口统计学和生活方式因素的信息。使用连续睡眠参数作为因变量，抑郁状态作为自变量拟合线性回归模型。多变量模型针对体重指数、婚姻状况、吸烟状况、教育水平和儿童残疾情况进行了调整。
结果
使用八项患者健康问卷得分≥10，26.3%的参与者存在抑郁。与未抑郁的女性相比，抑郁女性更有可能自我报告总体（主观）睡眠较差；然而，使用活动记录仪（客观）睡眠特征时，睡眠差异并不一致。在抑郁者中，睡眠时间和卧床总时间均被显著低估。在多变量模型中，使用主观（β=-0.71，标准误[SE]=0.25；P=0.006）和客观睡眠（β=-0.42，SE=0.19；P=0.026）时，抑郁与睡眠时间均呈负相关。
结论
睡眠与抑郁之间的关联在比较主观和客观评估方法时有所不同。鼓励采用能够整合睡眠特征的感知和客观测量的研究策略。
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