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


(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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    • "" Babson, Trainor, Feldner, and Blumenthal (2010) also found that total sleep deprivation is associated with next-day low positive affect, as defined by feeling slowed down, bored, withdrawn, and needing extra effort to get moving. Franzen, Siegle, and Buysse (2008) found that one night of sleep deprivation led to lower subjective reports of positive mood as well. Objective measures of emotional reactivity (based on pupil dilation while viewing positive, neutral, and negative visual stimuli) did not differ between the sleep-deprived and nonsleep-deprived participants when viewing positive images, however. "
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    ABSTRACT: This chapter discusses the bidirectional association between sleep duration or quality and sadness, which is broadly defined as low positive affect. Regarding the impact of sleep on sadness and depression, observational and experimental studies suggest that poor sleep quality and insufficient sleep lead to low positive affect among depression-free individuals, but individuals with depression respond to the challenge of sleep deprivation with transient mood elevation. Regarding the impact of low mood on sleep, studies generally find little to no evidence supporting the hypothesis that, among people without depression, a low arousal negative affect, such as sadness, predicts poor sleep the next night. On the other hand, people with depression experience greater sleep abnormalities than do people without depression, including difficulties initiating and maintaining sleep and disturbances in rapid eye movement (REM) sleep. The chapter also discusses how depression and sad mood could contribute to the severity of insomnia, circadian rhythm sleep-wake disorders, and sleep apnea.
    Sleep and Affect, 12/2015: pages 227-245; , ISBN: 9780124171886
    • "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; 24(11). 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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