Improved Sleep Quality is Associated with Reductions in Depression and PTSD Arousal Symptoms and Increases in IGF-1 Concentrations

Abstract

predict depression reoccurrence, 7 which highlights the critical importance of treating underlying sleep disturbances in patients with mood and anxiety disorders to maintain psychiatric recovery, especially in the often stressful period of deployment readjustment. Although sleep disturbance represents a strong risk factor for depression and PTSD, less is known regarding the impact of targeting sleep disturbances directly to improve BRIEF SUMMARY Current Knowledge/Study Rationale: Previous studies recognized a relationship between sleep disturbance and psychiatric morbidity; however, limited work has examined this link in military personnel, a cohort at elevated risk for both insomnia and psychopathology. The current study examines the relation between improved sleep and attenuation of depression and posttraumatic symptoms in military personnel, as well as changes in trophic factors that likely modulate these conditions. Study Impact: Results indicate a strong association between improved sleep and reduced psychiatric symptoms, as well as enriched healthrelated quality of life. Sleep-focused treatments may be an effective means to facilitate psychiatric recovery. Findings highlight the importance of conducting sleep assessments in military personnel with mood and anxiety disorders.Study Objectives: One-third of deployed military personnel will be diagnosed with insomnia, placing them at high risk for comorbid depression, posttraumatic stress disorder (PTSD), and medical conditions. The disruption of trophic factors has been implicated in these comorbid conditions, which can impede postdeployment recovery. This study determined if improved sleep quality is associated with (1) reductions in depression and posttraumatic symptoms, as well as enrichments in health-related quality of life (HRQOL), and (2) changes in plasma concentrations of brain derived neurotrophic factor (BDNF) and insulin-like growth factor-1 (IGF-1). Methods: Forty-four military personnel diagnosed with insomnia underwent clinical evaluations and blood draws at pretreatment and at posttreatment following cognitive behavioral therapy for insomnia and automatic positive airway pressure treatment. Participants were classifi ed as sleep improved (n = 28) or sleep declined (n = 16) based on their change in pretreatment to posttreatment Pittsburgh Sleep Quality Index (PSQI) score. Both groups were compared on outcomes of depression, PTSD, HRQOL, BDNF, and IGF-1. Results: Paired t-tests of the sleep improved group revealed signifi cant declines in depression (p = 0.005) and posttraumatic arousal (p = 0.006) symptoms, and a signifi cant increase in concentrations of IGF-1 (p = 0.009). The sleep declined group had no relevant change in psychiatric symptoms or trophic factors, and had further declines on fi ve of eight dimensions of HRQOL. Between-group change score differences were signifi cant at p < 0.05. Conclusions: These fi ndings suggest that interventions, which successfully improve sleep quality, are an effective means to reduce the depression and ...

Stress-altered synaptic plasticity and DAMP signaling in the hippocampus-PFC axis; elucidating the significance of IGF-1/IGF-1R/CaMKIIα expression in neural changes associated with a prolonged exposure therapy

“…Furthermore, IGF-1R is known to directly regulate the activity of dopamine and glutamate at post-synaptic terminals by directly altering the activity of N-methyl-D-aspartate receptor (NMDAR R) and dopaminergic D2R (la Cour et al, 2011; Quesada et al, 2011; Kelinridders et al, 2014). Thus, some of the effect on IGF-1/IGF-1R on complex behaviors may be linked to its role in the combined regulation of dopaminergic and glutamatergic neurotransmission (Bouallegue et al, 2009; Hu et al, 2016; Gao et al, 2014; Davis et al, 2000; Dong and Zhang, 2015; Rusch et al, 2015). …”

Evaluation of the Quality of Sleep of the Professional Soldiers Population

“…Results of studies Rusch et al (2015) emphasize the importance of raising the quality of sleep in reducing symptoms of depression, trauma and cognitive performance among military personnel. Group of soldiers diagnosed with insomnia was defined as a group of high risk for the development of disturbances coexisting: depression, posttraumatic stress disorder, and other due to sleep disorders.…”

A review of the physiological and psychological health and wellbeing of naval service personnel and the modalities used for monitoring

“…The most common form of data collection in relation to the sleep habits of military personnel are questionnaires. Questionnaires include the Pittsburgh sleep quality index [304], sleep disorder scale [305], Epworth sleepiness scale [306], the Bergen insomnia scale [307], the Stanford sleepiness scale [308] and other self-report methods [309]. As already discussed, a lack of sleep can cause many issues, especially on-board navy vessels.…”