Relationship of depression and sleep quality, diseases and general characteristics

Table 1 Relationship of Patient Health Questionnaire-9 items and depression

PHQ-9 item	Score	Mild (n = 139)		Moderate (n = 49)		Moderately severe (n = 22)		Severe (n = 11)
		n	Percent	n	Percent	n	Percent	n	Percent
Item 1	0	32	23.02	2	4.08	0	0.00	0	0.00
	1	67	48.20	11	22.45	5	22.73	1	9.09
	2	36	25.90	27	55.10	10	45.45	2	18.18
	3	4	2.88	9	18.37	7	31.82	8	72.73
Item 2	0	62	44.60	8	16.33	1	4.55	0	0.00
	1	62	44.60	14	28.57	4	18.18	0	0.00
	2	15	10.79	24	48.98	14	63.64	3	27.27
	3	0	0.00	3	6.12	3	13.64	8	72.73
Item 3	0	10	7.19	0	0.00	0	0.00	1	9.09
	1	41	29.50	12	24.49	2	9.09	0	0.00
	2	52	37.41	19	38.78	9	40.91	1	9.09
	3	36	25.90	18	36.73	11	50.00	9	81.82
Item 4	0	17	12.23	3	6.12	0	0.00	0	0.00
	1	66	47.48	9	18.37	1	4.55	0	0.00
	2	48	34.53	28	57.14	10	45.45	1	9.09
	3	8	5.76	9	18.37	11	50.00	11	100.00
Item 5	0	69	49.64	10	20.41	3	13.64	0	0.00
	1	49	35.25	20	40.82	5	22.73	3	27.27
	2	19	13.67	17	34.69	7	31.82	1	9.09
	3	2	1.44	2	4.08	7	31.82	7	63.64
Item 6	0	102	73.38	16	32.65	2	9.09	2	18.18
	1	32	23.02	24	48.98	5	22.73	0	0.00
	2	4	2.88	9	18.37	10	45.45	1	9.09
	3	1	0.72	0	0.00	5	22.73	8	72.73
Item 7	0	85	61.15	15	30.61	1	4.55	0	0.00
	1	44	31.65	17	34.69	2	9.09	1	9.09
	2	9	6.47	14	28.57	12	54.55	2	18.18
	3	1	0.72	3	6.12	7	31.82	8	72.73
Item 8	0	105	75.54	17	34.69	6	27.27	0	0.00
	1	28	20.14	25	51.02	5	22.73	0	0.00
	2	5	3.60	6	12.24	9	40.91	3	27.27
	3	1	0.72	1	2.04	2	9.09	8	72.73
Item 9	0	134	96.40	40	81.63	13	59.09	3	27.27
	1	5	3.60	7	14.29	5	22.73	5	45.45
	2	0	0.00	2	4.08	2	9.09	1	9.09
	3	0	0.00	0	0.00	2	9.09	2	18.18

PHQ-9: Patient Health Questionnaire-9.

Table 2 Relationship of Pittsburgh sleep quality index components and depression

PSQI index	Score	Without (n = 190)		With (n = 221)		Mild (n = 139)		Moderate (n = 49)		Moderately severe (n = 22)		Severe (n = 11)
		n	Percent	n	Percent	n	Percent	n	Percent	n	Percent	n	Percent
Subjective sleep quality	0	0	0.00	3	1.36	2	1.44	1	2.04	0	0.00	0	0.00
	1	87	45.79	27	12.22	22	15.83	4	8.16	1	4.55	0	0.00
	2	94	49.47	146	66.06	94	67.63	33	67.35	11	50.00	8	72.73
	3	9	4.74	45	20.36	21	15.11	11	22.45	10	45.45	3	27.27
Sleep latency	0	9	4.74	8	3.62	3	2.16	4	8.16	1	4.55	0	0.00
	1	52	27.37	31	14.03	23	16.55	5	10.20	3	13.64	0	0.00
	2	77	40.53	69	31.22	45	32.37	13	26.53	8	36.36	3	27.27
	3	52	27.37	113	51.13	68	48.92	27	55.10	10	45.45	8	72.73
Sleep duration	0	46	24.21	39	17.65	27	19.42	6	12.24	4	18.18	2	18.18
	1	62	32.63	68	30.77	42	30.22	19	38.78	4	18.18	3	27.27
	2	59	31.05	60	27.15	39	28.06	13	26.53	8	36.36	0	0.00
	3	23	12.11	54	24.43	31	22.30	11	22.45	6	27.27	6	54.55
Habitual sleep efficiency	0	64	33.68	48	21.72	34	24.46	10	20.41	3	13.64	1	9.09
	1	44	23.16	42	19.00	27	19.42	10	20.41	4	18.18	1	9.09
	2	41	21.58	48	21.72	28	20.14	12	24.49	4	18.18	4	36.36
	3	41	21.58	83	37.56	50	35.97	17	34.69	11	50.00	5	45.45
Sleep disturbances	0	3	1.58	2	0.90	1	0.72	1	2.04	0	0.00	0	0.00
	1	154	81.05	135	61.09	99	71.22	25	51.02	8	36.36	3	27.27
	2	32	16.84	79	35.75	37	26.62	22	44.90	13	59.09	7	63.64
	3	1	0.53	5	2.26	2	1.44	1	2.04	1	4.55	1	9.09
Use of sleeping medications	0	85	44.74	90	40.72	63	45.32	19	38.78	6	27.27	2	18.18
	1	28	14.74	15	6.79	9	6.47	4	8.16	1	4.55	1	9.09
	2	43	22.63	40	18.10	32	23.02	8	16.33	0	0.00	0	0.00
	3	34	17.89	76	34.39	35	25.18	18	36.73	15	68.18	8	72.73
Daytime dysfunction	0	161	84.74	94	42.53	71	51.08	18	36.73	5	22.73	0	0.00
	1	27	14.21	84	38.01	53	38.13	18	36.73	9	40.91	4	36.36
	2	2	1.05	37	16.74	14	10.07	12	24.49	6	27.27	5	45.45
	3	0	0.00	6	2.71	1	0.72	1	2.04	2	9.09	2	18.18

PSQI: Pittsburgh sleep quality index.

Table 3 Comparison of diseases status between without depression and with depression groups, n (%)

Diseases	Status	Without depression	With depression	P value
Diagnosed depression	Yes	17 (8.95)	52 (23.53)	< 0.001
	No	173 (91.05)	169 (76.47)
Chronic diseases	Yes	60 (31.58)	68 (30.77)	0.86
	No	130 (68.42)	153 (69.23)
High blood pressure	Yes	100 (52.63)	114 (51.58)	0.83
	No	90 (47.37)	107 (48.42)
Diabetes	Yes	49 (25.79)	58 (26.24)	0.92
	No	141 (74.21)	163 (73.76)
Coronary heart disease	Yes	21 (11.05)	42 (19)	0.03
	No	169 (88.95)	179 (81)
Cerebrovascular disease	Yes	14 (7.37)	25 (11.31)	0.17
	No	176 (92.63)	196 (88.69)
Enlarged prostate	Yes	9 (4.74)	14 (6.33)	0.48
	No	181 (95.26)	207 (93.67)
Cancer	Yes	6 (3.16)	8 (3.62)	0.80
	No	184 (96.84)	213 (96.38)
Mental illness	Yes	1 (0.53)	12 (5.43)	0.01
	No	189 (99.47)	209 (94.57)
Tuberculosis	Yes	0 (0)	1 (0.45)	0.35
	No	190 (100)	220 (99.55)
Chronic hepatitis	Yes	1 (0.53)	3 (1.36)	0.39
	No	189 (99.47)	218 (98.64)
Cirrhosis	Yes	3 (1.58)	2 (0.9)	0.53
	No	187 (98.42)	219 (99.1)

Table 4 Comparison of general characteristics between without depression and with depression groups, n (%)

Characteristics	Status	Without depression	With depression	P value
Gender	Male	51 (26.84)	55 (24.89)	0.65
	Female	139 (73.16)	166 (75.11)
Age (yr)		59.36 ± 7.46	59.66 ± 8.36	0.71
Education	Elementary school and below	2 (1.05)	4 (1.81)	0.04
	Junior high school	25 (13.16)	52 (23.53)
	Secondary school or high school	73 (38.42)	66 (29.86)
	University and above	90 (47.37)	99 (44.8)
Marital status	Unmarried	6 (3.16)	10 (4.52)	0.05
	Married	170 (89.47)	178 (80.54)
	Divorced	5 (2.63)	18 (8.14)
	Widowed	9 (4.74)	15 (6.79)
Living situation	Living alone	11 (5.79)	36 (16.29)	0.002
	Live with husband or wife	113 (59.47)	112 (50.68)
	Live with children	61 (32.11)	60 (27.15)
	Other	5 (2.63)	13 (5.88)
Occupational	On-the-job	55 (28.95)	49 (22.17)	0.29
	Retire	130 (68.42)	166 (75.11)
	Unemployed	5 (2.63)	6 (2.71)
Income (yuan)	0-2000	4 (2.11)	9 (4.07)	0.09
	2000-4000	53 (27.89)	81 (36.65)
	4000-6000	71 (37.37)	78 (35.29)
	≥ 6000	62 (32.63)	53 (23.98)
Exercise	Yes	150 (78.95)	138 (62.44)	< 0.001
	No	40 (21.05)	83 (37.56)

Table 5 Comparison of insomnia related characteristics between without depression and with depression groups, n (%)

Indicator	Status	Without depression	With depression	P value
Years of insomnia		5.21 ± 6.06	7.35 ± 7.48	< 0.001
Western medicine treatment	Yes	102 (53.68)	143 (64.71)	0.02
	No	88 (46.32)	78 (35.29)
Chinese medicine treatment	Yes	82 (43.16)	143 (64.71)	< 0.001
	No	108 (56.84)	78 (35.29)
Psychotherapy	Yes	6 (3.16)	25 (11.31)	0.002
	No	184 (96.84)	196 (88.69)
Kinds of insomnia	Difficult to fall asleep	89 (46.84)	140 (63.35)	< 0.001
	Difficult to deep sleep	20 (10.53)	16 (7.24)
	Easy to wake up	53 (27.89)	36 (16.29)
	Wake up early	28 (14.74)	29 (13.12)
Events related to insomnia	Work pressure	42 (22.11)	40 (18.1)	0.10
	Family life	58 (30.53)	66 (29.86)
	Disease related	49 (25.79)	82 (37.1)
	Sleep environment	37 (19.47)	31 (14.03)
	Interpersonal communication	4 (2.11)	2 (0.9)
Treatment expected to treat insomnia	Western medicine	53 (27.89)	36 (16.29)	< 0.001
	Traditional Chinese Medicine	97 (51.05)	133 (60.18)
	Psychotherapy	14 (7.37)	36 (16.29)
	Other	26 (13.68)	16 (7.24)
Traditional Chinese medicine foot bath	Yes	50 (26.32)	49 (22.17)	0.33
	No	140 (73.68)	172 (77.83)
Acupressure	Yes	51 (26.84)	50 (22.62)	0.32
	No	139 (73.16)	171 (77.38)
Psychological counseling	Yes	1 (0.53)	19 (8.6)	< 0.001
	No	189 (99.47)	202 (91.4)
Medicated diet	Yes	16 (8.42)	28 (12.67)	0.17
	No	174 (91.58)	193 (87.33)
Tai Chi	Yes	11 (5.79)	5 (2.26)	0.07
	No	179 (94.21)	216 (97.74)
Traditional Chinese medicine	Yes	93 (48.95)	120 (54.3)	0.28
	No	97 (51.05)	101 (45.7)
Other traditional Chinese medicine	Yes	17 (8.95)	16 (7.24)	0.53
	No	173 (91.05)	205 (92.76)
Habit of 1 hour before bed	Electronic products	79 (41.58)	125 (56.56)	< 0.001
	Reading news or papers	31 (16.32)	22 (9.95)
	Chat	7 (3.68)	10 (4.52)
	Fitness	0 (0)	1 (0.45)
	None	12 (6.32)	26 (11.76)
	Watch TV	61 (32.11)	37 (16.74)
Habit of drinking tea	Yes	57 (30)	81 (36.65)	0.16
	No	133 (70)	140 (63.35)
Habit of drinking coffee	Yes	38 (20)	35 (15.84)	0.27
	No	152 (80)	186 (84.16)
Habit of drinking spirits	Yes	3 (1.58)	10 (4.52)	0.09
	No	187 (98.42)	211 (95.48)
Habit of smoking	Yes	24 (12.63)	19 (8.6)	0.18
	No	166 (87.37)	202 (91.4)
Habit of lunch break	Yes	52 (27.37)	82 (37.1)	< 0.001
	No	138 (72.63)	139 (62.9)

Table 6 Logistic analysis of depression and the significant characteristics

Characteristics	Univariate analysis					Multivariate analysis
	Wals	P value	OR	95% CI of OR		Wals	P value	OR	95% CI of OR
				Lower	Upper				Lower	Upper
Education	5.58	0.02	0.71	0.54	0.94	6.08	0.01	0.71	0.55	0.93
Living situation	0.38	0.54	0.91	0.67	1.23
Exercise	5.63	0.02	1.81	1.11	2.95	9.89	< 0.001	2.09	1.32	3.31
Years of insomnia	3.40	0.07	1.03	1.00	1.07
Western medicine treatment	1.05	0.31	0.79	0.50	1.24
Chinese medicine treatment	0.70	0.40	1.20	0.78	1.82
Psychotherapy	1.30	0.25	0.53	0.18	1.57
Kinds of insomnia	5.95	0.01	0.79	0.65	0.95	8.79	< 0.001	0.76	0.63	0.91
Treatment expected to treat insomnia	0.74	0.39	1.12	0.87	1.44
Psychological counseling	2.96	0.09	0.15	0.02	1.30
Habit of 1 hour before bed	3.97	0.04	0.90	0.81	1.00	5.48	0.02	0.89	0.81	0.98
Habit of lunch break	0.12	0.73	1.08	0.68	1.71
Diagnosed depression	4.64	0.03	0.48	0.24	0.94	12.94	< 0.001	0.32	0.17	0.60
Coronary heart disease	5.91	0.02	0.46	0.25	0.86	7.43	0.01	0.43	0.23	0.79
Mental illness	2.87	0.09	0.16	0.02	1.34

OR: Odds ratio.