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This study examines the prevalence of sleeping difficulties and their relationship to depression and anxiety in 1328 subjects aged 57?79 years by means of a questionnaire. Difficulties initiating sleep (DIS), difficulties maintaining sleep (DMS), early morning awakenings (EMA), and nightmares were assessed with The Uppsala Sleep Inventory (USI) and depression and anxiety with The Hospital Anxiety and Depression Scale (HAD scale). A total of 20.4% reported severe sleeping difficulties (DIS, DMS, or EMA), with a female preponderance. On the basis of the HAD scale we found that 3.4% fulfilled the criteria for ''definite depression'' and 10.1% fulfilled the criteria for ''possible depression''. The prevalence of ''definite'' and ''possible pure anxiety'' (anxiety without depression) was 2.7% and 8.1%, respectively. There was no sex difference in reports of depression, but women more often reported pure anxiety. Altogether, 24.3% of the sample had either depression or anxiety. Nightmares were reported by 2.2% of the sample and associated with both depression and anxiety. We found that 39% of respondents with definite depression and 45.2% with definite pure anxiety reported sleeping difficulties. Depression emerged as the variable most consistently associated with sleeping difficulties when depression, pure anxiety, age, and sex were considered simultaneously. Habitual sleeping pill use was reported by 31.1% of the subjects with definite depression, whereas only 24.4% received antidepressive medication. These findings indicate that sleeping difficulties often are associated with psychiatric symptoms, especially depression.

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