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.
- SourceAvailable from: Pandi-Perumal Seithikurippu Ratnas
[Show abstract] [Hide abstract]
- "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
- [Show abstract] [Hide abstract]
ABSTRACT: Deals with a kind of cellular robotic system (CEBOT), called self organizing manipulator system. In this system the configuration of the manipulator can be changed according to the given task. The authors use two manipulators to assemble, disassemble, and reassemble cellular universal manipulator by cooperation work. When a simple task is given, the system can analyze the task and generate the structure of the cellular manipulator. The assembling work was divided into modular subtasks, and then the system generate the macro command based on the database. The order of subtask and the collision avoidance are considered for planning the cooperation work by using the collision database which was calculated before hand. They show the algorithm for calculation the collision database and for planning the cooperation work. The results of the simulation and the experiment are shownIntelligent Robots and Systems '91. 'Intelligence for Mechanical Systems, Proceedings IROS '91. IEEE/RSJ International Workshop on; 12/1991
- [Show abstract] [Hide abstract]
ABSTRACT: The application of interleaving techniques is a very common practice in the construction of transformers for electronic circuits, in order to reduce the AC resistance and leakage inductance. However, the effects of the interleaving techniques on the capacitive effects is not so well known. This work presents a study of the quantification of the benefits that can be achieved applying interleaving techniques between different layers (interlayer effect) and in the same layer (intralayer effect). The sensitivity of the leakage inductance, AC resistance and capacitive effects is studied in this work. Some design guidelines are extracted in order to select the best winding strategy for each transformer. The analysis has been carried out by means of finite element analysis (FEA) techniques in order to take into account all the frequency and geometry effectsApplied Power Electronics Conference and Exposition, 1998. APEC '98. Conference Proceedings 1998., Thirteenth Annual; 03/1998