Insomnia is a key risk factor for persistent anxiety and depressive symptoms: A 12-month longitudinal cohort study during the COVID-19 pandemic.

Humans Female Male Depression / epidemiology COVID-19 / epidemiology Pandemics Longitudinal Studies Sleep Initiation and Maintenance Disorders / epidemiology Anxiety / epidemiology Risk Factors Cohort Studies
Acute insomnia Anxiety Depression Insomnia Pre-sleep arousal Trajectories

Journal

Journal of affective disorders
ISSN: 1573-2517
Titre abrégé: J Affect Disord
Pays: Netherlands
ID NLM: 7906073

Informations de publication

Date de publication:
01 02 2023
Historique:
received: 09 05 2022
revised: 26 08 2022
accepted: 07 11 2022
pubmed: 14 11 2022
medline: 7 12 2022
entrez: 13 11 2022
Statut: ppublish

Résumé

Insomnia is a risk factor for affective disorders. This study examined whether individuals with insomnia symptoms early in the pandemic, either pre-existing or new-onset, were more vulnerable to anxiety and depressive symptoms over time than those who maintained normal sleep. Additionally, sleep-related factors such as pre-sleep arousal were assessed for their influence on clinically significant anxiety and depression risk. Using a global online survey with 3-, 6-, and 12-month follow-ups between April 2020 and May 2021, data from 2069 participants (M = 46.16 ± 13.42 years; 75.3 % female) with pre-existing, new-onset, or no insomnia symptoms was examined using mixed-effects and logistic regression models. New-onset and pre-existing insomnia predicted persistent anxiety and depressive symptoms longitudinally (p's < 0.001), over other known risk factors, including age, sex, and previous psychiatric diagnoses. Anxiety and depressive symptoms in both insomnia groups remained above clinically significant thresholds at most time points, whereas normal sleepers remained subclinical. Pre-sleep arousal was found to increase the risk of clinically significant anxiety (OR = 1.05) and depressive symptoms (OR = 1.09) at 12-months. Sleep effort contributed to anxiety (OR = 1.06), whereas dysfunctional sleep-related beliefs and attitudes predicted clinically significant depression (OR = 1.22). Insomnia group categorization was based on self-report at baseline supported by a validated measure. High participant attrition was observed at 3-months (53 %; n = 971), but retention remained steady till 12-months (63 %, n = 779). Insomnia is a modifiable risk factor for persistent anxiety and depressive symptoms that needs to be addressed in mental healthcare. Additionally, pre-sleep arousal may be an important transdiagnostic process linking insomnia with affective disorders.

Sections du résumé

BACKGROUND
Insomnia is a risk factor for affective disorders. This study examined whether individuals with insomnia symptoms early in the pandemic, either pre-existing or new-onset, were more vulnerable to anxiety and depressive symptoms over time than those who maintained normal sleep. Additionally, sleep-related factors such as pre-sleep arousal were assessed for their influence on clinically significant anxiety and depression risk.
METHODS
Using a global online survey with 3-, 6-, and 12-month follow-ups between April 2020 and May 2021, data from 2069 participants (M = 46.16 ± 13.42 years; 75.3 % female) with pre-existing, new-onset, or no insomnia symptoms was examined using mixed-effects and logistic regression models.
RESULTS
New-onset and pre-existing insomnia predicted persistent anxiety and depressive symptoms longitudinally (p's < 0.001), over other known risk factors, including age, sex, and previous psychiatric diagnoses. Anxiety and depressive symptoms in both insomnia groups remained above clinically significant thresholds at most time points, whereas normal sleepers remained subclinical. Pre-sleep arousal was found to increase the risk of clinically significant anxiety (OR = 1.05) and depressive symptoms (OR = 1.09) at 12-months. Sleep effort contributed to anxiety (OR = 1.06), whereas dysfunctional sleep-related beliefs and attitudes predicted clinically significant depression (OR = 1.22).
LIMITATIONS
Insomnia group categorization was based on self-report at baseline supported by a validated measure. High participant attrition was observed at 3-months (53 %; n = 971), but retention remained steady till 12-months (63 %, n = 779).
CONCLUSIONS
Insomnia is a modifiable risk factor for persistent anxiety and depressive symptoms that needs to be addressed in mental healthcare. Additionally, pre-sleep arousal may be an important transdiagnostic process linking insomnia with affective disorders.

Identifiants

DOI: 10.1016/j.jad.2022.11.021 PMID: 36372131
pubmed: 36372131
pii: S0165-0327(22)01268-X
doi: 10.1016/j.jad.2022.11.021
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

52-62

Informations de copyright

Copyright © 2022 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Conflict of Interest None of the authors have any conflicts of interest to disclose.

Auteurs

Hailey Meaklim (H)

Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia.

William J Saunders (WJ)

Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia.

Michelle L Byrne (ML)

Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia; Department of Psychology, University of Oregon, Eugene, OR, USA; The Sleep Health Foundation, Blacktown, New South Wales, Australia.

Moira F Junge (MF)

Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia; School of Educational Psychology and Counselling, Faculty of Education, Monash University, Victoria, Australia.

Prerna Varma (P)

Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia.

Wendy A Finck (WA)

School of Educational Psychology and Counselling, Faculty of Education, Monash University, Victoria, Australia.

Melinda L Jackson (ML)

Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Victoria, Australia. Electronic address: melinda.jackson@monash.edu.

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Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Insomnia is a key risk factor for persistent...
questionsmedicales.fr › Comportement et mécanismes comportementaux › Émotions › Dépression › Insomnia is a key risk factor for persistent...
questionsmedicales.fr › Maladies de l'appareil respiratoire › Infections de l'appareil respiratoire › Pneumopathie infectieuse › Pneumopathie virale › COVID-19 › Insomnia is a key risk factor for persistent...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Épidémies de maladies › Épidémies › Pandémies › Insomnia is a key risk factor for persistent...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études longitudinales › Insomnia is a key risk factor for persistent...
questionsmedicales.fr › Troubles mentaux › Troubles de la veille et du sommeil › Dyssomnies › Troubles du sommeil d'origine intrinsèque › Troubles de l'endormissement et du maintien du sommeil › Insomnia is a key risk factor for persistent...
questionsmedicales.fr › Comportement et mécanismes comportementaux › Émotions › Anxiété › Insomnia is a key risk factor for persistent...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Statistiques comme sujet › Probabilité › Risque › Facteurs de risque › Insomnia is a key risk factor for persistent...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Insomnia is a key risk factor for persistent...