Neckelmann D, Mykletun A, Dahl AA. Chronic insomnia as a risk factor for developing anxiety and depression. Sleep 30: 873-80

Department of Psychiatry, Clinic ofPsychosomatic Medicine, Haukeland University Hospital, Bergen, Norway.
Sleep (Impact Factor: 4.59). 08/2007; 30(7):873-80.
Source: PubMed


To study prospectively the relations of insomnia to the development of anxiety disorders and depression in a population-based sample.
Cohort study based on data from 2 general health surveys of the adult population.
Two general health surveys in the adult population in Nord-Trøndelag County of Norway, HUNT-1 performed in 1984-6 and HUNT-2 in 1995-7
Participants without significant anxiety and depression in HUNT-1 were categorized according to the presence and absence of insomnia in the 2 surveys (N=25,130).
Anxiety disorders and depression in HUNT-2 were assessed by the Hospital Anxiety and Depression Scale and analyzed using multivariate logistic regression analysis adjusted for age, gender, education, comorbid depression/anxiety, and history of insomnia. Anxiety disorders in HUNT-2 were significantly associated with the group with insomnia in HUNT-1 only (OR 1.6; 95% CI, 1.1-2.3), the group with insomnia in HUNT-2 only (OR 3.4; 95% CI, 3.1-3.8), as well as with the group with insomnia in both surveys (OR 4.9; 95% CI, 3.8-6.4). Depression in HUNT-2 was significantly associated with the group with insomnia in HUNT-2 only (OR 1.8; 95% CI, 1.6-2.0), but not with the groups with insomnia in HUNT-1 only or with insomnia in both surveys.
Only a state-like association between insomnia and depression was found. In addition to being a state marker, insomnia may be a trait marker for individuals at risk for developing anxiety disorders. Results are consistent with insomnia being a risk factor for the development of anxiety disorders.

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Available from: Alv Andreas Dahl, Jun 18, 2014
    • "Disruption to sleep can occur for a number of reasons including age and hormones and can also be an associated symptom of disorders such as dementia or anxiety. Primary sleep disorders such as insomnia, hypersomnia and parasomnia are associated with increased risk of obesity, cardiovascular disease and may be an independent risk factor for mental health problems such as depression (Riemann 2007; Neckelmann et al 2007; Hicks and Green 2012). Additionally, Banks and Dinges (2007) emphasised the importance of adequate sleep highlighting the numerous neurological deficits associated with restricted sleep, including slowed working memory, reduced cognitive throughput and depressed mood. "
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    • "For example, insomnia is associated with greater tendencies toward rumination and worry, and increased frequency of intrusive thoughts characterized by negative emotional content before falling asleep (Nicassio et al. 1985; Espie 2002; Guastella & Moulds 2007). Additionally, there is evidence that insomnia represents an independent risk factor for the development of anxiety and mood disorders (Johnson et al. 2006; Neckelmann et al. 2007), and that short-term cognitive behavioral treatment for insomnia leads to substantial reductions in comorbid psychiatric symptoms (for a review, see Smith et al. (2005)). "
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    • "It also can be a manifestation of an underlying medical disorder, psychiatric/behavioural disorder or medication usage [7] [8]. The social, economic, psychological and physical implications of insomnia are substantial, with evidence linking the condition to an increased risk of hypertension [9], cardiovascular disease [10], anxiety [11], and depression [12] [13], as well as impaired quality of life [14], work absenteeism, workrelated accidents, poor work efficiency, and family dysfunction [15]. "
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