Sleep disturbances and their relationship with anxiety-depressive symptoms and quality of life in older adults: a retrospective observational study

OBJECTIVES: To investigate the prevalence of sleep disorders in the elderly and explore their relationships with anxiety, depressive symptoms, and quality of life. METHODS: This single-center retrospective study included 120 elderly inpatients from the psychiatry department of our hospital between December 2020 and December 2025. Demographic and clinical data, along with Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), Patient Health Questionnaire-9 (PHQ-9), 12-Item Short Form Health Survey (SF-12) scores and the Chinese version of the Montreal Cognitive Assessment Scale (MoCA-C), were collected. Patients were categorized into sleep disturbance (SD, PSQI>5) and non-sleep disturbance (NSD, PSQI≤5) groups. Group differences were analyzed, and multivariate logistic regression and Spearman correlation were performed. RESULTS: Of the 120 patients, 50 (41.7 %) had sleep disturbances. The SD group showed significantly higher anxiety and depression scores and lower SF-12 and MoCA scores than the NSD group (all p<0.05). The total PSQI score was strongly positively correlated with HADS anxiety, HADS depression, and PHQ-9 scores (r=0.413-0.514, p<0.001), and significantly negatively correlated with SF-12 PCS, SF-12 MCS, and MoCA-C scores (r=-0.683 to -0.476, p<0.001). Multivariate logistic regression identified chronic pain (OR=3.580, 95 % CI: 1.444-8.879, p=0.006), long-term sedative-hypnotic use (OR=2.860, 95 % CI: 1.136-7.200, p=0.026), and psychological loneliness (OR=5.261, 95 % CI: 2.006-13.798, p=0.001) as independent risk factors for sleep disorders in the elderly. CONCLUSIONS: In this hospital-based sample of older psychiatric patients, sleep disturbances in older adults are significantly associated with anxiety, depression, and reduced quality of life, particularly mental health. Early screening and targeted interventions are warranted.