{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T13:19:01Z","timestamp":1787923141809,"version":"build-2784847793"},"reference-count":38,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Sleep Research"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Sleep and sleep disturbances, such as sleep apnoea and insomnia, are linked to mental health, particularly, depressive symptoms. It remains unclear however, if sleep fragmentation or hypoxia is primarily linked to depressive symptoms and how insomnia symptoms affect this relationship in samples free of clinical referral bias. We analysed cross\u2010sectional data from two harmonised, population\u2010based cohorts: the Sleep and HEalth in women (SHE) study and the Men Androgen Inflammation Lifestyle Environment and Stress (MAILES) study (\n                    <jats:italic>n<\/jats:italic>\n                    <jats:sub>total<\/jats:sub>\n                    \u2009=\u20091238; 68% males, 57\u2009\u00b1\u200912\u2009years, BMI 28.0\u2009\u00b1\u20094.2\u2009kg\/m\n                    <jats:sup>2<\/jats:sup>\n                    ). Objective measures of OSA (apnoea\u2013hypopnoea index; AHI, oxygen desaturation index; ODI) and sleep fragmentation variables (sleep efficiency; SE% and wake after sleep onset; WASO) were measured, along with subjective data on insomnia symptoms and depressive symptoms. Logistic regression models were used to assess associations while adjusting for age, sex, BMI, alcohol and physical activity. Pathway analyses further explored potential mediating relationships. Depressive symptoms were present in 17% of the sample. We did not find a link between intermittent hypoxia variables (AHI, ODI) and depressive symptoms. In contrast, reduced SE% (OR 0.84; 0.72\u20130.98) and increased WASO (1.26; 1.06\u20131.51) were significantly related to depressive symptoms. When including adjustment for insomnia in the model, these associations were no longer significant. While sleep fragmentation was associated with depressive symptoms, insomnia symptoms appear to be a key factor. Assessing insomnia in depression and vice versa and addressing these conditions, may be useful for reducing symptom burden.\n                  <\/jats:p>","DOI":"10.1111\/jsr.70431","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T12:22:30Z","timestamp":1787919750000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of Sleep, Sleep Apnoea and Insomnia Symptoms on Depressive Symptoms in Combined harmonised Community\u2010Based Cohorts\u2014A Cross\u2010Sectional Analysis"],"prefix":"10.1111","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2819-2799","authenticated-orcid":false,"given":"Jenny","family":"Theorell\u2010Hagl\u00f6w","sequence":"first","affiliation":[{"name":"Department of Medical Sciences, Respiratory, Allergy and Sleep Research Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary A.","family":"Wittert","sequence":"additional","affiliation":[{"name":"School of Medicine University of Adelaide  Adelaide South Australia Australia"},{"name":"Freemasons Centre for Male Health and Wellbeing South Australian Health and Medical Research Institute  Adelaide South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert J.","family":"Adams","sequence":"additional","affiliation":[{"name":"Freemasons Centre for Male Health and Wellbeing South Australian Health and Medical Research Institute  Adelaide South Australia Australia"},{"name":"Flinders Health and Medical Research Institute (Sleep Health), College of Medicine and Public Health Flinders University  Bedford Park South Australia Australia"},{"name":"AISH Sleep Health Clinics Flinders University  Bedford Park South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah L.","family":"Appleton","sequence":"additional","affiliation":[{"name":"Freemasons Centre for Male Health and Wellbeing South Australian Health and Medical Research Institute  Adelaide South Australia Australia"},{"name":"Flinders Health and Medical Research Institute (Sleep Health), College of Medicine and Public Health Flinders University  Bedford Park South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulf","family":"Hammar","sequence":"additional","affiliation":[{"name":"Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory Uppsala University  Uppsala Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9534-8699","authenticated-orcid":false,"given":"Amy C.","family":"Reynolds","sequence":"additional","affiliation":[{"name":"Flinders Health and Medical Research Institute (Sleep Health), College of Medicine and Public Health Flinders University  Bedford Park South Australia Australia"},{"name":"AISH Sleep Health Clinics Flinders University  Bedford Park South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel S.","family":"Marshall","sequence":"additional","affiliation":[{"name":"Centre for Research and Understanding of Sleep (CIRUS) Woolcock Institute for Medical Research, Macquarie University  Sydney Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/22.5.667"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-3999(02)00447-6"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.2147\/NSS.S359437"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neubiorev.2017.01.032"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.5406"},{"issue":"4","key":"e_1_2_12_7_1","first-page":"331","article-title":"Quantification of Subjective Sleep Quality in Healthy Elderly Men and Women Using the Pittsburgh Sleep Quality Index (PSQI)","volume":"14","author":"Buysse D. J.","year":"1991","journal-title":"Sleep"},{"issue":"12","key":"e_1_2_12_8_1","first-page":"16","article-title":"Prevalence of Insomnia for Canadians Aged 6 to 79","volume":"29","author":"Chaput J. P.","year":"2018","journal-title":"Health Reports"},{"key":"e_1_2_12_9_1","unstructured":"Chronic Insomnia Disorder in Australia. n.d.\u201cSpecial Sleep Reports.\u201dAccessed November 28 2025.https:\/\/www.sleephealthfoundation.org.au\/special\u2010sleep\u2010reports\/chronic\u2010insomnia\u2010disorder\u2010in\u2010australia."},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2215\u20100366(20)30136\u2010X"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleh.2018.01.003"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyt064"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/dyn262"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.181.4102.856"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/sjop.12343"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2018.10.006"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2022.101597"},{"key":"e_1_2_12_18_1","volume-title":"The AASM Manual for the Scoring of Sleep and AssociatedEvents: Rules, Terminology and Technical Specifications","author":"Iber C.","year":"2007"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2019.03.011"},{"issue":"4","key":"e_1_2_12_20_1","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1093\/sleep\/24.4.425","article-title":"Insomnia in Men \u2010 A 10\u2010Year Prospective Poulation Based Study","volume":"24","author":"Janson C.","year":"2001","journal-title":"Sleep"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1525\u20101497.2001.016009606.x"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.6546"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1111\/resp.13064"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11325\u2010017\u20101550\u20101"},{"issue":"1","key":"e_1_2_12_25_1","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1093\/oxfordjournals.aje.a008657","article-title":"Physical Activity Levels and Changes in Relation to Longevity. A Prospective Study of Swedish Women","volume":"143","author":"Lissner L.","year":"1996","journal-title":"American Journal of Epidemiology"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.158.2.255"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1111\/jsr.14252"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.1016\/0021\u20109681(79)90012\u20102"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2016.02.060"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2021.101519"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/jsr.70114"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00074907"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2010.06.014"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/33.5.593"},{"issue":"6","key":"e_1_2_12_35_1","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1093\/sleep\/29.6.751","article-title":"What Are the Important Risk Factors for Daytime Sleepiness and Fatigue in Women?","volume":"29","author":"Theorell\u2010Hagl\u00f6w J.","year":"2006","journal-title":"Sleep"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/jsr.14089"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsmc.2008.11.003"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2019.05.012"},{"key":"e_1_2_12_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0447.1983.tb09716.x"}],"container-title":["Journal of Sleep Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jsr.70431","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/jsr.70431","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/jsr.70431","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T12:22:32Z","timestamp":1787919752000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/jsr.70431"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,28]]},"references-count":38,"alternative-id":["10.1111\/jsr.70431"],"URL":"https:\/\/doi.org\/10.1111\/jsr.70431","archive":["Portico"],"relation":{},"ISSN":["0962-1105","1365-2869"],"issn-type":[{"value":"0962-1105","type":"print"},{"value":"1365-2869","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,28]]},"assertion":[{"value":"2025-12-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-06","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70431"}}