Anxiety symptoms and objectively measured sleep quality in older women

OBJECTIVES:: Few studies have examined the association between anxiety symptoms and objectively measured sleep quality in older adults. The authors determined this association in a large cohort of very old community-dwelling women. DESIGN:: Cross-sectional. SETTING:: Participants' homes, sites of the Study of Osteoporotic Fractures. PARTICIPANTS:: Three thousand forty women (mean age: 83.6 years) enrolled in a prospective study of aging. MEASUREMENTS:: Participants completed the Goldberg Anxiety Scale (ANX), the 15-item Geriatric Depression Scale (GDS), and ≥3 nights of actigraphy-a method of measuring sleep by recording wrist movement with a device called an actigraph. Elevated anxiety symptoms were defined as ANX ≥6. Elevated depressive symptoms were defined as GDS ≥6. RESULTS:: Participants' mean ANX score was 1.4 (standard deviation: 2.2); 9.2% (N ≤ 280) had ANX ≥6. Elevated anxiety symptoms were associated with greater odds of poor sleep efficiency (odds ratio [OR]: 1.73, 95% confidence interval [CI]: 1.34, 2.23) and time awake after sleep onset (OR: 1.64, 95% CI: 1.27, 2.11). Associations remained after adjustment for GDS ≥6, antianxiety medications, and other potential confounders (sleep efficiency OR: 1.50, 95% CI: 1.15, 1.97; time awake after sleep onset OR: 1.33, 95% CI: 1.01, 1.75). Anxiety symptoms were not associated with other sleep parameters. CONCLUSION:: Findings suggest that elevated anxiety symptoms are independently associated with poor objectively measured sleep efficiency and elevated sleep fragmentation in very old women, after accounting for significant depressive symptoms, medical comorbidities, and use of antianxiety medications.