Subjective-Device-Estimated Sleep Discrepancies in Late-Life Depression: Agreement and Associated Factors

Area of Science:

• Gerontology
• Sleep Medicine
• Psychiatry

Background:

• Late-life depression presents unique challenges in sleep assessment.
• Discrepancies between subjective and objective sleep measures are common in this population.

Purpose of the Study:

• To evaluate the agreement between subjective sleep reports and device-estimated sleep parameters in patients with late-life depression.
• To identify factors contributing to the observed discrepancies in sleep assessment.

Main Methods:

• A cross-sectional study involving 94 patients diagnosed with late-life depression.
• Portable sleep respiratory monitoring for device-estimated sleep parameters (total sleep time, sleep onset latency, sleep efficiency).
• Bland-Altman analysis for agreement assessment and multivariate regression for factor identification.

Main Results:

• Significant discrepancies were found between subjective and device-estimated sleep parameters (TST, SOL, SE).
• Subjective reports tended to underestimate total sleep time and sleep efficiency, and overestimate sleep onset latency.
• Higher depressive symptom severity was associated with underestimation of total sleep time; later age at first onset correlated with underestimation of sleep efficiency.

Conclusions:

• Subjective-device-estimated sleep discrepancies are prevalent in late-life depression.
• Depressive symptom severity and age at first onset are associated with specific sleep parameter misjudgments.
• Integrating subjective and device-estimated sleep assessments is recommended for comprehensive patient evaluation.