A bidirectional relationship between anxiety and depression, and insomnia? A prospective study in the general population

Jansson‐Fröjmark, Markus; Lindblom, Karin

doi:10.1016/j.jpsychores.2007.10.016

Cited by 529 publications

(342 citation statements)

References 21 publications

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“…36 Furthermore, a number of studies have indicated a bidirectional relationship between poor sleep and depression; some have suggested that sleep difficulties may lead to or exacerbate depression and that by improving sleep quality it is possible to improve symptoms of depression as well. 37,38 OSA severity was not related to depression in our study and others have reported similar results, suggesting that depression is more related to disrupted sleep and sleepiness than OSA severity per se. 9 One limitation of the current study is that OSA was evaluated with a type 3 sleep study rather than a full polysomnography.…”

Section: Table 4-predictivesupporting

confidence: 77%

The Prevalence of Depression among Untreated Obstructive Sleep Apnea Patients Using a Standardized Psychiatric Interview

Björnsdóttir

Benediktsdóttir

Pack

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives: The aims of this study were: (1) to use a standardized psychiatric interview, conducted by a trained psychologist to assess the prevalence of depression among patients with untreated OSA, and (2) to identify if OSA severity or other comorbid disorders (insomnia, hypertension, and diabetes) are related to depression among patients with untreated OSA. Methods: Participants were newly diagnosed patients with OSA (n = 284) waiting to start positive airway pressure (PAP) treatment. The Mini International Neuropsychiatric Interview (MINI) was used to assess depression. Results: Overall, 15.5% of the sample met the diagnosis for dysthymia. Women had a significantly higher prevalence (29.5% versus 11.7% among men, p < 0.001). The prevalence of major depression was 6% in the overall sample and there was no difference in the prevalence among sexes (5.8% among men versus 6.6 % among women). Obesity, daytime sleepiness, low physical activity, initial and late insomnia, low quality of life, and sleep medication and antidepressant use were all related to depression, whereas OSA severity, as measured by apnea-hypopnea index or oxygen desaturation index, was not. Daytime sleepiness, initial insomnia, and sleep medication use were the strongest predictors of depression in multivariable analyses. Conclusions: Sleep medication use, daytime sleepiness, and symptoms of initial insomnia were independently related to depression but OSA severity was not. Increased awareness of the relationship between depression and OSA and the appropriate use of assessment tools might substantially improve diagnostic accuracy as well as treatment outcome for both disorders.

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Section: Table 4-predictivesupporting

confidence: 77%

The Prevalence of Depression among Untreated Obstructive Sleep Apnea Patients Using a Standardized Psychiatric Interview

Björnsdóttir

Benediktsdóttir

Pack

et al. 2016

Journal of Clinical Sleep Medicine

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“…Depression and anxiety are among the most common psychiatric disorders that accompany insomnia (5,6). It seems that there is a bilateral relationship between insomnia and these emotional disorders to an extent that insomnia contributes to depressive and anxiety symptoms and these symptoms can lead to sleep disturbances, too (7). Conceptual similarities between the new models of insomnia and emotional disorders indicate that the key contributing factors in insomnia are similar to the proposed cognitive and behavioral factors in emotional disorders (8).…”

Section: Introductionmentioning

confidence: 92%

Investigating the Effects of the Unified Protocol on Common and Specific Factors in a Comorbid Insomniac Sample: A Single-Case Experimental Design

Vand

Gharraee

Farid

et al. 2018

Iran J Psychiatry Behav Sci

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Background: Insomnia and emotional disorders share common factors that underlie and perpetuate these disorders. The Unified Protocol (UP) for the transdiagnostic treatment of emotional disorders is a new treatment approach designed to target core processes of emotional disorders. Objectives: The present study examined the effects of UP on behavioral inhibition/behavioral activation, anxiety sensitivity, and emotion dysregulation as transdiagnostic factors, as well as cognition and behaviors specific to insomnia, in a small sample of patients (N = 6) with comorbid insomnia and emotional disorders. Methods: A multiple-baseline across subjects single-case experimental design with a 3-month follow-up was used. Participants were allocated to 2, 4, and 6 baseline periods and then received 14 weekly individual sessions of UP. The outcome measures were Behavioral Inhibition/Behavioral Activation Scales (BIS/BAS), Anxiety Sensitivity Index-3 (ASI-3), Difficulties in Emotion Regulation Questionnaire (DERS), Dysfunctional Beliefs and Attitudes about Sleep Scale-10 (DBAS-10), and Sleep-Related Behaviors Questionnaire (SRBQ). Data were analyzed using visual inspection, mixed model analysis, and reliable change index (RCI). Results:The mixed model analysis showed significant changes in BIS/BAS, ASI-3, DERS, DBAS-10, and SRBQ from pre-treatment to post-treatment. Most participants achieved a reliable change in BIS, ASI-3, DERS, DBAS-10, and SRBQ at a 3-month follow-up. Conclusions: This preliminary study provides empirical evidence on the utility of UP for reducing common vulnerability and sleepspecific factors in chronic insomnia comorbid with emotional disorders. Further research is needed to test these findings in randomized controlled studies.

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“…A bidirectional relationship has been identified in the literature. 17,18 Researchers have also determined that patients diagnosed with severe insomnia are 6 times more likely to have had a prior mental illness. 14 One study found that the odds of having at least one psychiatric diagnosis was 5.04 times greater in patients with severe insomnia as compared to those without insomnia and that increasing insomnia severity was associated with increased chronic medical and psychiatric illnesses.…”

Section: Psychiatric Comorbiditiesmentioning

confidence: 99%

Treatment of Insomnia with Comorbid Mental Illness

Skaer¹

2012

Can't Sleep? Issues of Being an Insomniac

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A bidirectional relationship between anxiety and depression, and insomnia? A prospective study in the general population

Cited by 529 publications

References 21 publications

The Prevalence of Depression among Untreated Obstructive Sleep Apnea Patients Using a Standardized Psychiatric Interview

The Prevalence of Depression among Untreated Obstructive Sleep Apnea Patients Using a Standardized Psychiatric Interview

Investigating the Effects of the Unified Protocol on Common and Specific Factors in a Comorbid Insomniac Sample: A Single-Case Experimental Design

Treatment of Insomnia with Comorbid Mental Illness

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