Sleep disorders as core symptoms of depression

Links between sleep and depression are strong. About three quarters of depressed patients have insomnia symptoms, and hypersomnia is present in about 40% of young depressed adults and 10% of older patients, with a preponderance in females. The symptoms cause huge distress, have a major impact on quality of life, and are a strong risk factor for suicide. As well as the subjective experience of sleep symptoms, there are well-documented changes in objective sleep architecture in depression. Mechanisms of sleep regulation and how they might be disturbed in depression are discussed. The sleep symptoms are often unresolved by treatment, and confer a greater risk of relapse and recurrence. Epidemiological studies have pointed out that insomnia in nondepressed subjects is a risk factor for later development of depression. There is therefore a need for more successful management of sleep disturbance in depression, in order to improve quality of life in these patients and reduce an important factor in depressive relapse and recurrence.

[1]  R. Armitage.  Sleep and circadian rhythms in mood disorders , 2007, Acta psychiatrica Scandinavica. Supplementum.

[2]  A. Steiger,et al.  Nocturnal secretion of prolactin and cortisol and the sleep EEG in patients with major endogenous depression during an acute episode and after full remission , 1997, Psychiatry Research.

[3]  U. Hemmeter,et al.  Effect of flumazenil-augmentation on microsleep and mood in depressed patients during partial sleep deprivation. , 2007, Journal of psychiatric research.

[4]  B. Mulsant,et al.  Residual symptoms and recurrence during maintenance treatment of late-life depression. , 2007, Journal of affective disorders.

[5]  D. Katz,et al.  The relationship between insomnia and health-related quality of life in patients with chronic illness. , 2002, The Journal of family practice.

[6]  M. Thase,et al.  Abnormal electroencephalographic sleep profiles in major depression: association with response to cognitive behavior therapy. , 1996, Archives of general psychiatry.

[7]  M. Ohayon,et al.  Place of chronic insomnia in the course of depressive and anxiety disorders. , 2003, Journal of psychiatric research.

[8]  Enrico Smeraldi,et al.  Actimetric evidence that CLOCK 3111 T/C SNP influences sleep and activity patterns in patients affected by bipolar depression , 2007, American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics.

[9]  F. Benazzi.  The Symptoms of Atypical Depression , 2003, Canadian journal of psychiatry. Revue canadienne de psychiatrie.

[10]  D J Kupfer,et al.  Self-reported sleep disturbance as a prodromal symptom in recurrent depression. , 1997, Journal of affective disorders.

[11]  A. Borbély.  A two process model of sleep regulation. , 1982, Human neurobiology.

[12]  Daniel J Buysse,et al.  Which depressed patients will respond to interpersonal psychotherapy? The role of abnormal EEG sleep profiles. , 1997, The American journal of psychiatry.

[13]  C. Cusin,et al.  Insomnia improvement during antidepressant treatment and CLOCK gene polymorphism , 2005, American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics.

[14]  S. Modell,et al.  Rapid eye movement (REM) sleep: An endophenotype for depression , 2007, Current psychiatry reports.

[15]  M. Ağargün,et al.  Sleep disturbances and suicidal behavior in patients with major depression. , 1997, The Journal of clinical psychiatry.

[16]  Christian Degueldre,et al.  Functional Neuroanatomy of Human Slow Wave Sleep , 1997, The Journal of Neuroscience.

[17]  Derk-Jan Dijk,et al.  Timing and Consolidation of Human Sleep, Wakefulness, and Performance by a Symphony of Oscillators , 2005, Journal of biological rhythms.

[18]  Anna Wirz-Justice,et al.  Sleep deprivation in depression: what do we know, where do we go? , 1999, Biological Psychiatry.

[19]  D. Baldwin,et al.  Quantifying subjective assessment of sleep and life‐quality in antidepressant‐treated depressed patients , 2003, Human psychopharmacology.

[20]  W. Drevets,et al.  Orbitofrontal Cortex Function and Structure in Depression , 2007, Annals of the New York Academy of Sciences.

[21]  R. Thisted,et al.  Sleep and Psychiatric Disorders: A Meta-analysis , 1992 .

[22]  A. Rush,et al.  Latency to rapid eye movement sleep as a predictor of treatment response to fluoxetine and placebo in nonpsychotic depressed outpatients , 1994, Psychiatry Research.

[23]  D. Nutt,et al.  NAPSAQ-1: National Patient Sleep Assessment Questionnaire in depression , 2009, International journal of psychiatry in clinical practice.

[24]  J. Lindesay,et al.  Insomnia comorbidity and impact and hypnotic use by age group in a national survey population aged 16 to 74 years. , 2006, Sleep.

[25]  D. Ford,et al.  Insomnia in young men and subsequent depression. The Johns Hopkins Precursors Study. , 1997, American journal of epidemiology.

[26]  M. Fava,et al.  Eszopiclone Co-Administered With Fluoxetine in Patients With Insomnia Coexisting With Major Depressive Disorder , 2006, Biological Psychiatry.

[27]  R. Salomon,et al.  Serotonin and the neurobiology of depression. Effects of tryptophan depletion in drug-free depressed patients. , 1994, Archives of general psychiatry.

[28]  Gwenn S. Smith,et al.  Glucose metabolic response to total sleep deprivation, recovery sleep, and acute antidepressant treatment as functional neuroanatomic correlates of treatment outcome in geriatric depression. , 2002, The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry.

[29]  P. Haynes,et al.  Disrupting life events and the sleep-wake cycle in depression , 2006, Psychological Medicine.

[30]  D. Nutt.  Neurobiological mechanisms in generalized anxiety disorder. , 2001, The Journal of clinical psychiatry.

[31]  D. Ford,et al.  Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention? , 1989, JAMA.

[32]  Monte S Buchsbaum,et al.  Sleep deprivation PET correlations of Hamilton symptom improvement ratings with changes in relative glucose metabolism in patients with depression. , 2008, Journal of affective disorders.

[33]  A. Ontiveros,et al.  A randomized, open-label comparison of venlafaxine and fluoxetine in depressed outpatients. , 1998, Clinical therapeutics.

[34]  A. Rush,et al.  Reduced rapid eye movement latency. A predictor of recurrence in depression. , 1987, Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology.

[35]  M. Fava,et al.  Clinical features of depression in outpatients with and without co-occurring general medical conditions in STAR*D: confirmatory analysis. , 2007, Primary care companion to the Journal of clinical psychiatry.

[36]  M. Thase,et al.  Effects of Sertraline on Sleep Architecture in Patients With Depression , 2003, Journal of clinical psychopharmacology.

[37]  J. Kelsoe,et al.  Rapid tryptophan depletion, sleep electroencephalogram, and mood in men with remitted depression on serotonin reuptake inhibitors. , 1998, Archives of general psychiatry.

[38]  F. Holsboer,et al.  The Munich vulnerability study on affective disorders: stability of polysomnographic findings over time , 2002, Biological Psychiatry.

[39]  P. Croft,et al.  Epidemiology of insomnia: a longitudinal study in a UK population. , 2007, Sleep.

[40]  D. Nutt,et al.  Randomised controlled study of sleep after nefazodone or paroxetine treatment in out-patients with depression. , 2002, The British journal of psychiatry : the journal of mental science.

[41]  M. Hamilton,et al.  Frequency of Symptoms in Melancholia (Depressive Illness) , 1989, British Journal of Psychiatry.

[42]  A. Rush,et al.  Polysomnographic findings in recently drug-free and clinically remitted depressed patients. , 1986, Archives of general psychiatry.

[43]  M. Thase,et al.  Treatment of insomnia associated with clinical depression. , 2004, Sleep medicine reviews.

[44]  Sue J. Wilson,et al.  Sleep disturbances in depression and the effects of antidepressants , 2005, International review of psychiatry.

[45]  T. Roth,et al.  Sleep disturbance and psychiatric disorders: A longitudinal epidemiological study of young Adults , 1996, Biological Psychiatry.

[46]  A. Leon,et al.  Residual symptoms in depressed patients after treatment with fluoxetine or reboxetine. , 2005, The Journal of clinical psychiatry.

[47]  Sue J. Wilson,et al.  Antidepressants and sleep: a qualitative review of the literature. , 2005, Drugs.

[48]  E. Smeraldi,et al.  Phase Advance Is an Actimetric Correlate of Antidepressant Response to Sleep Deprivation and Light Therapy in Bipolar Depression , 2007, Chronobiology international.

[49]  S. Farooqui,et al.  Changes in monoamines and their metabolite concentrations in REM sleep-deprived rat forebrain nuclei , 1996, Pharmacology Biochemistry and Behavior.

[50]  Z. Segal,et al.  A comparison of rates of residual insomnia symptoms following pharmacotherapy or cognitive-behavioral therapy for major depressive disorder. , 2007, The Journal of clinical psychiatry.