Associations of depression, sleep disorder with total and cause-specific mortality: A prospective cohort study

Objective: Evidence on the association of depression and sleep disorder with mortality is limited. We aimed to evaluate the relationship of depression and sleep disorder with mortality. Methods: A total of 25,978 participants from the National health and Nutrition Examination Surveys (NHANES 2005-2014) were included in the present study. Cox proportional hazards models were used to explore the associations of depression and sleep disorder with total and cause-specific mortality. Results: A total of 1,864 deaths occurred among 25,978 participants during a median follow-up of 5.67 years, including 301 deaths from cardiovascular diseases (CVD) and 415 deaths from cancer. We observed significant positive relationship between depression and total and CVD mortality, the multiple adjusted hazard rations (HRs) and 95% confidence intervals (CIs) were 1.56 (1.31-1.85) and 2.11 (1.36-3.30), respectively. Sleep disorder was only significantly associated with total mortality, and the HR and 95% CI was 1.49 (1.28-1.72). Sleep disorder was associated with total mortality in male (HR=1.64, 95% CI 1.29-2.08), excessive sleep time increased the risk of total mortality in elders (1.31, 1.05-1.63). No joint effect of depression and sleep disorder on total mortality was observed. A dose-response relationship of depression score and sleep time with total mortality was observed. Conclusions: Depression and sleep disorder are associated with increased risks of total and specific-cause mortality, and differences in sex, age and BMI were observed. More studies should be conducted to examine these relationships and to explore mechanisms.