Prevalence, course, and comorbidity of insomnia and depression in young adults. Sleep

Department ofPsychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA.
Sleep (Impact Factor: 4.59). 05/2008; 31(4):473-80. DOI: 10.5167/uzh-10110
Source: PubMed

ABSTRACT (1) To describe the prevalence and prospective course of insomnia in a representative young-adult sample and (2) to describe the cross-sectional and longitudinal associations between insomnia and depression.
Longitudinal cohort study.
Community of Zurich, Switzerland.
Representative stratified population sample.
The Zurich Study prospectively assessed psychiatric, physical, and sleep symptoms in a community sample of young adults (n=591) with 6 interviews spanning 20 years. We distinguished 4 duration-based subtypes of insomnia: 1-month insomnia associated with significant distress, 2- to 3-week insomnia, recurrent brief insomnia, and occasional brief insomnia. The annual prevalence of 1-month insomnia increased gradually over time, with a cumulative prevalence rate of 20% and a greater than 2-fold risk among women. In 40% of subjects, insomnia developed into more chronic forms over time. Insomnia either with or without comorbid depression was highly stable over time. Insomnia lasting 2 weeks or longer predicted major depressive episodes and major depressive disorder at subsequent interviews; 17% to 50% of subjects with insomnia lasting 2 weeks or longer developed a major depressive episode in a later interview. "Pure" insomnia and "pure" depression were not longitudinally related to each other, whereas insomnia comorbid with depression was longitudinally related to both.
This longitudinal study confirms the persistent nature of insomnia and the increased risk of subsequent depression among individuals with insomnia. The data support a spectrum of insomnia (defined by duration and frequency) comorbid with, rather than secondary to, depression.

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    • "Difficulties initiating and maintaining sleep are considered part of the diagnosis of insomnia (Johnson, Roth, Schultz, & Breslau, 2006). They often co-occur with psychiatric difficulties such as depression and anxiety (Buysse et al., 2008), and have been associated with diminished adolescent psychosocial functioning and health (Roberts, "
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    ABSTRACT: Despite the importance of parenting practices for adolescent adjustment, parenting correlates of adolescent sleep functioning remain understudied. This study delineated patterns of sleep functioning in a sample of ethnically diverse, low-income, adolescents and examined associations among three types of parenting practices (parental involvement, parent-child conflict, and parental control) and adolescent sleep functioning (difficulties initiating sleep and maintaining sleep, and sleep duration). Adolescents (N = 91, 11-19 years old) self-reported on sleep functioning and parenting practices. Results showed that in the preceding month, 60.5% of adolescents had difficulties initiating sleep and 73.6% had difficulties maintaining sleep. Most adolescents slept 8 or more hours per night, but 30.7% slept less than 8 hours. Latino adolescents slept longer and had fewer difficulties maintaining sleep than non-Latino. High school students had fewer difficulties maintaining sleep than their middle school counterparts; conversely, older adolescents experienced shorter sleep duration than younger ones. Adolescents whose parents had post-secondary education had shorter sleep duration than those whose parents had not graduated from high school. Parental control was correlated with fewer difficulties initiating sleep, whereas parent-child conflict was correlated with more difficulties maintaining sleep. There were no parenting correlates of sleep duration. Latino adolescents had better sleep profiles than non-Latino ones. Regression analyses showed that parental control and parent-child conflict were associated with adolescent sleep functioning across ethnicities. Results suggest that parenting practices, as well as demographic characteristics, are associated with adolescent sleep functioning and should be taken into account in interventions aimed at improving sleep functioning among adolescents.
    Journal of Child and Family Studies 04/2015; DOI:10.1007/s10826-015-0135-5 · 1.42 Impact Factor
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    • "Insomnia is rarely seen in isolation. It is highly comorbid with various other health conditions (Ohayon, Caulet, & Lemoine, 1998), particularly depression (Buysse et al., 2008). In fact, insomnia is considered a major risk factor for the development of a major depressive episode (Riemann & Voderholzer, 2003; Baglioni et al., 2011). "
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    ABSTRACT: Greater sleep difficulty following a challenging event, or a vulnerability to stress-related sleep disturbance (i.e., sleep reactivity), is characteristic of insomnia. However, insomnia is rarely observed in isolation; rather it is frequently seen in combination with other problems, such as depression. Despite the link between depression and increased sensitivity to stress, relatively little is known about the role sleep reactivity has in explaining variability in depressive symptoms. Therefore, the current study examined whether sleep reactivity was associated with depressive symptoms, and whether this relationship was mediated by insomnia. We assessed sleep reactivity, insomnia, and depressive symptoms among 2250 young adults (1244 female; M age = 23.1, SD age = 2.97) from the Colorado Longitudinal Twin Study and Community Twin Study. Results indicated that greater sleep reactivity was significantly associated with elevated depressive symptoms, and that this link was partially mediated by insomnia. This is one of the first studies to demonstrate an independent association between sleep reactivity and depressive symptomatology. These findings suggest that a greater sensitivity to stress-related sleep disturbance may also be a predisposing factor to depression, and highlight the need for a better understanding of sleep reactivity, as it may represent a more global vulnerability construct. Keywords
    03/2015; 1(1). DOI:10.1037/tps0000015
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    • "Depression and sleep are interrelated. A cardinal feature of depression is disturbed sleep.76,77 Depression is common during the college years: 14.8% of students report a diagnosis of depression and an estimated 11% have suicidal ideation.78 "
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    ABSTRACT: Daytime sleepiness, sleep deprivation, and irregular sleep schedules are highly prevalent among college students, as 50% report daytime sleepiness and 70% attain insufficient sleep. The consequences of sleep deprivation and daytime sleepiness are especially problematic to college students and can result in lower grade point averages, increased risk of academic failure, compromised learning, impaired mood, and increased risk of motor vehicle accidents. This article reviews the current prevalence of sleepiness and sleep deprivation among college students, contributing factors for sleep deprivation, and the role of sleep in learning and memory. The impact of sleep and sleep disorders on academics, grade point average, driving, and mood will be examined. Most importantly, effective and viable interventions to decrease sleepiness and sleep deprivation through sleep education classes, online programs, encouragement of naps, and adjustment of class time will be reviewed. This paper highlights that addressing sleep issues, which are not often considered as a risk factor for depression and academic failure, should be encouraged. Promotion of university and college policies and class schedules that encourage healthy and adequate sleep could have a significant impact on the sleep, learning, and health of college students. Future research to investigate effective and feasible interventions, which disseminate both sleep knowledge and encouragement of healthy sleep habits to college students in a time and cost effective manner, is a priority.
    Nature and Science of Sleep 06/2014; 6:73-84. DOI:10.2147/NSS.S62907
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