Insomnia and Sleep Duration in a Large Cohort of Patients With Major Depressive Disorder and Anxiety Disorders

NeuroCampus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands.
The Journal of Clinical Psychiatry (Impact Factor: 5.5). 03/2010; 71(3):239-46. DOI: 10.4088/JCP.09m05218gry
Source: PubMed


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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    • "Furthermore, sleep deprivation is associated with common psychiatric conditions such as anxiety and depression [van Mill et al., 2010]. While it is unclear to what extent sleep deprivation may be contributing to these conditions as opposed to resulting from them [van Mill et al., 2010], one study of military personnel has shown that individuals reporting symptoms of pre-deployment insomnia or short sleep (<6 hr of sleep a night) are more likely to suffer from new-onset post-deployment post-traumatic stress disorder (PTSD) Gehrman et al., 2013]. Thus, lifestyle changes and medical interventions that improve sleep quantity may lead to improved physical and emotional health. "
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    ABSTRACT: Sleep is critical to health and functionality, and several studies have investigated the inherited component of insomnia and other sleep disorders using genome-wide association studies (GWAS). However, genome-wide studies focused on sleep duration are less common. Here, we used data from participants in the Coriell Personalized Medicine Collaborative (CPMC) (n = 4,401) to examine putative associations between self-reported sleep duration, demographic and lifestyle variables, and genome-wide single nucleotide polymorphism (SNP) data to better understand genetic contributions to variation in sleep duration. We employed stepwise ordered logistic regression to select our model and retained the following predictive variables: age, gender, weight, physical activity, physical activity at work, smoking status, alcohol consumption, ethnicity, and ancestry (as measured by principal components analysis) in our association testing. Several of our strongest candidate genes were previously identified in GWAS related to sleep duration (TSHZ2, ABCC9, FBXO15) and narcolepsy (NFATC2, SALL4). In addition, we have identified novel candidate genes for involvement in sleep duration including SORCS1 and ELOVL2. Our results demonstrate that the self-reported data collected through the CPMC are robust, and our genome-wide association analysis has identified novel candidate genes involved in sleep duration. More generally, this study contributes to a better understanding of the complexity of human sleep.
    American Journal of Medical Genetics Part B Neuropsychiatric Genetics 09/2015; DOI:10.1002/ajmg.b.32362 · 3.42 Impact Factor
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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). "
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    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(1). 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 [17]. "
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    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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