Depression in sleep disturbance: A review on a bidirectional relationship, mechanisms and treatment

Abstract

Sleep disturbance is the most prominent symptom in depressive patients and was formerly regarded as a main secondary manifestation of depression. However, many longitudinal studies have identified insomnia as an independent risk factor for the development of emerging or recurrent depression among young, middle‐aged and older adults. This bidirectional association between sleep disturbance and depression has created a new perspective that sleep problems are no longer an epiphenomenon of depression but a predictive prodromal symptom. In this review, we highlight the treatment of sleep disturbance before, during and after depression, which probably plays an important role in improving outcomes and preventing the recurrence of depression. In clinical practice, pharmacological therapies, including hypnotics and antidepressants, and non‐pharmacological therapies are typically applied. A better understanding of the pathophysiological mechanisms between sleep disturbance and depression can help psychiatrists better manage this comorbidity.

Are one-year changes in adherence to the 24-hour Movement Guidelines associated with depressive symptoms among youth?

“…Our findings augment evidence of an inverse association between sleep and depressive symptoms (39,(41)(42)(43)45,52,53) and conflict with studies that found no prospective effect (54,77)or an effect in females only (46,47). Once considered a core symptom or comorbidity of depressive disorders, some now identify sleep problems as both a prodromal manifestation and an independent risk factor for subsequent episodes, predicting the occurrence and outcome of depressive disorders (78). In fact, given the inadequacy of treatments for youth depression (79), sleep therapy has been suggested as an intervention for adolescent MDD (79).…”

Are one-year changes in adherence to the 24-hour movement guidelines associated with depressive symptoms among youth?

“…Our findings augment evidence of an inverse association between sleep and depressive symptoms (2,37,(39)(40)(41)43,50,51) and conflict with studies that found no prospective effect (52,73)or an effect in females only (44,45). Once considered a core symptom or comorbidity of depressive disorders, some now identify sleep problems as both a prodromal manifestation and an independent risk factor for subsequent episodes, predicting the occurrence and outcome of depressive disorders (74). In fact,…”

Night work and postpartum depression: a national register-based cohort study

“…One possible explanation for the association between depression and changes of working schedules is that worsening of depressive symptoms in relation to night work may be more easily recognizable than other disorders, such as hormonal dysfunction. Furthermore, adequate sleep is one of the non-pharmacological therapies in the treatment of depression (48).…”