The Longitudinal and Cross-Sectional Associations of Grief and Complicated Grief With Sleep Quality in Older Adults

ABSTRACT

Objective/Background: About 15% of grievers experience complicated grief. We determined cross-sectional and longitudinal relations of grief and complicated grief with sleep duration and quality in the general population of elderly adults. Participants: We included 5,421 men and women from the prospective population-based Rotterdam Study. Methods: The Inventory of Complicated Grief was used to define grief and complicated grief. We assessed sleep with the Pittsburgh Sleep Quality Index. Results: After 6 years, 3,511 (80% of survivors) underwent the follow-up interview. Complicated grief was cross-sectionally associated with shorter sleep duration and lower sleep quality. These associations were explained by the presence of depressive symptoms. The prospective analyses showed that sleep duration and sleep quality did not decline further during follow-up of persons who experienced grief or complicated grief. Conclusion: In community-dwelling, middle-aged and older adults, persons with normal and complicated grief had both a shorter sleep duration and a lower sleep quality, mainly explained by depressive symptoms. However, prospective analyses showed that sleep quality and sleep duration do not decline further in persons with normal grief and complicated grief.

Acknowledgments

We want to thank all the persons who contributed to this article.

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Funding

The Rotterdam Study is supported by the Erasmus Medical Center and the Erasmus University Rotterdam; The Nederland’s Organization for Scientific Research (NWO); The Nederland’s Organization for Health Research and Development; the Ministry of Health, Welfare, and Sports; and the European Commission (DGXII). Jelena Milic was supported by an Erasmus Mundus (ERAWEB) grant. Henning Tiemeier was supported by the Vidi grant of the Netherlands Organization for Health Research and Development (ZonMw 2009-017.106.370). The funders had no role in the study design or data collection and analyses.