Insomnia and Sleep Duration in a Large Cohort of Patients With Major Depressive Disorder and Anxiety Disorders
ABSTRACT Disturbed sleep has a high impact on daily functioning and has been correlated with psychopathology. We investigated the extent to which insomnia and sleep duration were associated with both current and remitted depressive and anxiety disorders in a large-scale epidemiologic study, taking sociodemographics, health factors, and medication use into account.
Data of 2,619 individuals from the Netherlands Study of Depression and Anxiety (NESDA) were analyzed. Psychopathology was classified as no, current, or remitted DSM-IV-based diagnosis of major depressive or anxiety disorder. Outcome measures were insomnia (Women's Health Initiative Insomnia Rating Scale score >or= 9) and sleep duration (<or= 6 hours, 7-9 hours, >or= 10 hours). Baseline measurement was conducted between September 2004 and February 2007.
Both current and remitted depressive disorder and current anxiety disorder were associated with insomnia and short sleep duration with odds ratios (ORs) for insomnia ranging from 1.42 to 3.23 and for short sleep duration ranging from 1.41 to 2.53. Associations were stronger for current than for remitted diagnoses and stronger for depressive than for anxiety disorders. Also long sleep duration was associated with current depressive disorder and anxiety disorders (OR range, 1.53-2.66). Sociodemographic factors, health indicators, and psychotropic medication use did contribute to sleep outcomes but could not explain much of the psychopathology and sleep associations.
Depressive disorder-but also anxiety disorder-is strongly associated with sleep disturbances. Insomnia and short sleep duration persist after remittance of these disorders, suggesting that these are residual symptoms or possibly trait markers. Also, long sleep duration is associated with current depressive or anxiety disorders.
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- "However, the usual treatments for psychiatric disorders do not typically address the insomnia, with the consequence that for many patients their insomnia would persist even after their psychiatric symptoms had abated (Sánchez-Ortuño et al, 2012; van Mill et al, 2010). The reason for the resistance of insomnia to non-sleep interventions is that insomnia is maintained by sleep-related, non-adaptive cognitions and behaviors that are sleep specific and are independent of the comorbid condition (Taylor et al, 2005; Buysee et al, 2008; van Mill et al, 2010). Cognitive behavioural therapy for insomnia (CBT-I) specifically targets these insomnia perpetuating cognitions and behaviours and thus effectively alleviates insomnia in the presence of comorbid psychiatric and medical conditions (Watanabe et al, 2011; Shimodera et al, 2011; Sánchez-Ortuño et al, 2012; Wagley et al, 2013). "
ABSTRACT: Recent scientific evidences have brought a paradigm shift in our approach towards the concepts of insomnia and its management. The differentiation between primary and secondary insomnia was proved more hypothetical than actual and based upon the current evidences insomnia subtypes described in earlier system have been lumped into one-Insomnia Disorder. Research in this field suggests that insomnia occurring during psychiatric or medical disorders has a bidirectional and interactive relationship with and coexisting medical and psychiatric illnesses. The new approach looks to coexisting psychiatric or medical disorders as comorbid conditions and hence specifying two coexisting conditions. Therefore, the management and treatment plans should address both conditions. A number of sleep disorders may present with insomnia like symptoms and these disorders should be treated efficiently in order to alleviate insomnia symptoms. In such cases, a thorough history from the patient and his/her bed-partner is warranted. Moreover, some patients may need polysomnography or other diagnostic tests like actigraphy to confirm the diagnosis of the underlying sleep disorder. DSM-5 classification system of sleep-wake disorders has several advantages, e.g., it has seen insomnia across different dimensions to make it clinically more useful; it focuses on the assessment of severity and guides the mental health professional when to refer a patient of insomnia to a sleep specialist; lastly, it may encourage the psychiatrists to opt for the Sleep Medicine as a career.Asian Journal of Psychiatry 09/2014; 12. DOI:10.1016/j.ajp.2014.09.003
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- "Elderly people with no apparent disease participated in these experiments, and the subjects were classified as having sleep disorder based on interviews assessing the subjects' sleep disturbances. A variety of issues, including psychological problems (e.g., anxiety, depression, and stress [13, 14]), and painful physical conditions [15, 16], may cause sleep disorders. Research on the elderly has shown that sleep disorder is related to chronic disease, such as heart disease, lung disease, and osteoporosis . "
ABSTRACT: Introduction. According to traditional East Asian medicine (TEAM) theory, the tongue represents conditions of qi and blood. In the present study, the relationship between the tongue and the qi and blood in conditions with no apparent disease was investigated. Methods. A total of 454 elderly people with no apparent disease were recruited. Two Korean oriental medicine doctors classified subjects into a normal group (n = 402) and a sleep disorder group (n = 52). Three to five weeks after the experiment, 153 subjects were rerecruited for a second experiment. Two-dimensional color histograms, whose seven variables represent the color distribution in Commission Internationale de l'Éclairage 1976 (L∗, a∗, b∗) color space, were produced from tongue images. Results. The color of the tongue body in the sleep disorder group appeared paler than that in the normal group, and the tongue coating in the normal group was less widely distributed compared with that in the sleep disorder group. The differences in tongue color between the normal at first experiment and sleep disorder at second experiment conditions were similar to the differences between the normal and the sleep disorder groups. Conclusions. The tongue states in the sleep disorder group indicate a qi and blood deficiency according to TEAM theory.Evidence-based Complementary and Alternative Medicine 04/2014; 2014:323645. DOI:10.1155/2014/323645 · 1.88 Impact Factor
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- "Olfactory deficits are associated with a variety of disorders including, but not limited to Alzheimer’s Disease (Murphy, 1999), Parkinson’s disease (Doty, 2012), schizophrenia (Malaspina et al., 2012) and major depression (van Mill et al., 2010). All of these disorders are also associated with sleep disturbances such as insomnia and sleep fragmentation (Spiegelhalder et al., 2013). "
ABSTRACT: In many systems, sleep plays a vital role in memory consolidation and synaptic homeostasis. These processes together help store information of biological significance and reset synaptic circuits to facilitate acquisition of information in the future. In this review, we describe recent evidence of sleep-dependent changes in olfactory system structure and function which contribute to odor memory and perception. During slow-wave sleep, the piriform cortex becomes hypo-responsive to odor stimulation and instead displays sharp-wave activity similar to that observed within the hippocampal formation. Furthermore, the functional connectivity between the piriform cortex and other cortical and limbic regions is enhanced during slow-wave sleep compared to waking. This combination of conditions may allow odor memory consolidation to occur during a state of reduced external interference and facilitate association of odor memories with stored hedonic and contextual cues. Evidence consistent with sleep-dependent odor replay within olfactory cortical circuits is presented. These data suggest that both the strength and precision of odor memories is sleep-dependent. The work further emphasizes the critical role of synaptic plasticity and memory in not only odor memory but also basic odor perception. The work also suggests a possible link between sleep disturbances that are frequently co-morbid with a wide range of pathologies including Alzheimer's disease, schizophrenia and depression and the known olfactory impairments associated with those disorders.Frontiers in Behavioral Neuroscience 04/2014; 8:134. DOI:10.3389/fnbeh.2014.00134 · 4.16 Impact Factor