Insomnia and depression: How much is the overlap?

Comorbid insomnia fatigue mood sleep

Journal

Indian journal of psychiatry

ISSN: 0019-5545

Titre abrégé: Indian J Psychiatry

Pays: India

ID NLM: 0013255

Informations de publication

Date de publication:

Historique:

entrez: 4 1 2020

pubmed: 4 1 2020

medline: 4 1 2020

Statut: ppublish

Résumé

Previous literature considers insomnia as one of the features, predictor, and also as a residual symptom of depression. However, chronic insomnia and major depressive disorder (MDD) have overlapping features making differentiation between two difficult. Forty subjects in each of the three categories-MDD, insomnia (I) and combined diagnoses (MDD-I) were recruited in this study after excluding potential confounders. Diagnosis of MDD was made following Diagnostic and Statistical Manual 5 edition (DSM-5), while the International Classification of sleep disorders 3 edition criteria of insomnia were used for diagnosing insomnia. The severity of insomnia and depression was assessed using the Insomnia Severity Index (ISI) and Patient Health Questionnaire-9 (PHQ-9), respectively. Fatigue was assessed using the Fatigue Severity Scale (FSS), which was translated in Hindi for this study. All subjects were also asked regarding effect of good sleep at night on daytime symptoms, especially on mood. Subjects in MDD group were younger than the other two. Insomnia group was significantly different from the other two groups on most of the measures according to the DSM-5 criteria for MDD. MDD group had lesser frequencies of initial insomnia, middle insomnia, dissatisfaction with sleep and overall distress during the day. MDD-I group had a higher prevalence of daytime sleepiness and hyperactivity/impulsivity. PHQ-9 score was the lowest in the insomnia group. Despite statistically significantly different, ISI score was clinically comparable. The severity of fatigue was comparable across three groups. Contrary to the MDD group, subjects in insomnia and MDD-I group reported significant improvement in daytime symptoms after a good sleep for even one night. There is considerable overlap of symptoms between insomnia and MDD. Subjects having insomnia report significant improvement in daytime and mood symptoms after good sleep, contrary to subjects with MDD.

Sections du résumé

BACKGROUND BACKGROUND

MATERIALS AND METHODS METHODS

Forty subjects in each of the three categories-MDD, insomnia (I) and combined diagnoses (MDD-I) were recruited in this study after excluding potential confounders. Diagnosis of MDD was made following Diagnostic and Statistical Manual 5 edition (DSM-5), while the International Classification of sleep disorders 3 edition criteria of insomnia were used for diagnosing insomnia. The severity of insomnia and depression was assessed using the Insomnia Severity Index (ISI) and Patient Health Questionnaire-9 (PHQ-9), respectively. Fatigue was assessed using the Fatigue Severity Scale (FSS), which was translated in Hindi for this study. All subjects were also asked regarding effect of good sleep at night on daytime symptoms, especially on mood.

RESULTS RESULTS

Subjects in MDD group were younger than the other two. Insomnia group was significantly different from the other two groups on most of the measures according to the DSM-5 criteria for MDD. MDD group had lesser frequencies of initial insomnia, middle insomnia, dissatisfaction with sleep and overall distress during the day. MDD-I group had a higher prevalence of daytime sleepiness and hyperactivity/impulsivity. PHQ-9 score was the lowest in the insomnia group. Despite statistically significantly different, ISI score was clinically comparable. The severity of fatigue was comparable across three groups. Contrary to the MDD group, subjects in insomnia and MDD-I group reported significant improvement in daytime symptoms after a good sleep for even one night.

CONCLUSION CONCLUSIONS

There is considerable overlap of symptoms between insomnia and MDD. Subjects having insomnia report significant improvement in daytime and mood symptoms after good sleep, contrary to subjects with MDD.

Identifiants

DOI: 10.4103/psychiatry.IndianJPsychiatry_461_18 PMID: 31896870 PMC: PMC6862973

pubmed: 31896870

doi: 10.4103/psychiatry.IndianJPsychiatry_461_18

pii: IJPsy-61-623

pmc: PMC6862973

doi:

Types de publication

Journal Article

Langues

eng

Pagination

623-629

Informations de copyright

Déclaration de conflit d'intérêts

There are no conflicts of interest.

Références

Arch Neurol. 1989 Oct;46(10):1121-3

pubmed: 2803071

Emotion. 2010 Dec;10(6):831-41

pubmed: 21058849

J Behav Ther Exp Psychiatry. 2010 Sep;41(3):297-303

pubmed: 20231014

J Clin Psychiatry. 2012 Mar;73(3):377-83

pubmed: 22053828

Sleep. 2008 Apr;31(4):473-80

pubmed: 18457234

Int J MS Care. 2015 Nov-Dec;17(6):261-7

pubmed: 26664331

Sleep Med. 2014 Jul;15(7):825-32

pubmed: 24891081

Sleep. 2005 Nov;28(11):1457-64

pubmed: 16335332

J Gen Intern Med. 2001 Sep;16(9):606-13

pubmed: 11556941

J Clin Sleep Med. 2017 Oct 15;13(10):1171-1176

pubmed: 28859715

J Clin Sleep Med. 2015 Sep 15;11(9):1021-7

pubmed: 25845891

Sleep Med. 2017 Oct;38:122-129

pubmed: 29031746

Indian J Psychol Med. 2011 Jul;33(2):172-6

pubmed: 22345845

J Clin Psychiatry. 2007 Feb;68(2):254-60

pubmed: 17335324

BJPsych Open. 2017 Sep 25;3(5):228-235

pubmed: 28959453

World J Biol Psychiatry. 2009;10(4):269-75

pubmed: 19921968

Sleep Med. 2015 Aug;16(8):987-93

pubmed: 26141007

Sleep Sci. 2015 Nov;8(3):143-52

pubmed: 26779321

Int J Behav Med. 2014 Jun;21(3):506-10

pubmed: 24136401

J Psychosom Res. 2010 Nov;69(5):475-83

pubmed: 20955867

Psychosom Med. 2012 Sep;74(7):758-65

pubmed: 22879427

J Psychiatr Res. 2009 Feb;43(5):576-82

pubmed: 18954876

Sleep. 2008 Nov;31(11):1601-7

pubmed: 19014080

Encephale. 2004 May-Jun;30(3):222-7

pubmed: 15235519

J Psychiatr Res. 2003 Jan-Feb;37(1):9-15

pubmed: 12482465

PLoS One. 2018 Feb 13;13(2):e0192088

pubmed: 29438400

Sleep. 2014 Aug 01;37(8):1295-304

pubmed: 25083009

Int Psychogeriatr. 2018 Mar;30(3):431-435

pubmed: 28766467

Neural Plast. 2015;2015:581976

pubmed: 25878903

J Clin Sleep Med. 2013 Jun 15;9(6):567-75

pubmed: 23772190

Zhonghua Yi Xue Za Zhi. 2015 Aug 4;95(29):2355-8

pubmed: 26711069

Indian J Psychiatry. 2016 Jan-Mar;58(1):77-82

pubmed: 26985109

Sleep. 2011 Aug 01;34(8):1103-10

pubmed: 21804672

Neuropsychiatr Dis Treat. 2011;7:57-63

pubmed: 21430795

Sleep Med. 2017 Jan;29:41-46

pubmed: 28153215

J Clin Psychol. 2013 Oct;69(10):1043-55

pubmed: 23109266

Aust N Z J Psychiatry. 2001 Dec;35(6):827-32

pubmed: 11990894

Compr Psychiatry. 1998 Jul-Aug;39(4):185-97

pubmed: 9675502

Sleep Med. 2001 Jul;2(4):297-307

pubmed: 11438246

J Clin Sleep Med. 2013 Dec 15;9(12):1273-80

pubmed: 24340289

J Sleep Res. 2011 Sep;20(3):425-33

pubmed: 21205038