Insomnia in Patients With Depression: <i>A STAR*D Report</i>

Sunderajan, Prabha; Gaynes, Bradley N.; Wisniewski, Stephen R.; Miyahara, Sachiko; Fava, Maurizio; Akingbala, Felicia; DeVeaugh-Geiss, Joanne; Rush, A. John; Trivedi, Madhukar H.

doi:10.1017/s1092852900029266

Cited by 136 publications

(87 citation statements)

References 49 publications

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“…The second part of this finding is particularly important because insomnia is a common symptom of depression, 19 and depression is also frequent in patients with insomnia. 20 Frequent awakening, or middle insomnia, was associated with SI in the present study.…”

Section: Discussionmentioning

confidence: 99%

Is Insomnia Associated With Suicidality in Stroke?

Tang

Liang

et al. 2011

Archives of Physical Medicine and Rehabilitation

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Section: Discussionmentioning

confidence: 99%

Is Insomnia Associated With Suicidality in Stroke?

Tang

Liang

et al. 2011

Archives of Physical Medicine and Rehabilitation

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“…Estimated concordance rates for depression are as high as 80% to 90% in untreated patients. 1,2 Even after achieving remission from depression, half of these patients still suffer from residual insomnia. 3 Moreover, persistent insomnia might be a risk factor for depression relapse.…”

Section: S C I E N T I F I C I N V E S T I G a T I O N Smentioning

confidence: 99%

Change in Quality of Life after Brief Behavioral Therapy for Insomnia in Concurrent Depression: Analysis of the Effects of a Randomized Controlled Trial

Shimodera

Watanabe

Furukawa

et al. 2014

Journal of Clinical Sleep Medicine

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Study Objectives:The effi cacy of cognitive behavioral therapy for insomnia (CBT-I) has been suggested for insomnia concomitant with depression, but its impact on quality of life (QoL) has not been adequately evaluated. The study aimed to determine which aspects of QoL could be affected by CBT-I and how any changes in QoL were mediated by changes in insomnia and depression. Methods: We conducted a 4-week randomized controlled trial with 4-week follow-up in outpatient clinics in Japan. Thirtyseven patients with DSM-IV diagnosis of major depressive disorder concomitant with chronic insomnia were randomly assigned to the treatment-as-usual (TAU) alone arm or the TAU with brief behavioral therapy for insomnia (TAU plus psychotherapy) arm using modifi ed CBT-I consisting of 4 weekly individual sessions. We evaluated QoL using normbased scoring of the Short Form-36 at baseline and at 8 weeks. We also examined associations between QoL subscales and remission in insomnia or depression while controlling for baseline scores of the entire sample. Results:We tested group effects while controlling for baseline scores. TAU plus psychotherapy resulted in signifi cantly better scores on physical functioning (p = 0.006), social functioning (p = 0.002), and mental health (p = 0.041) subscales than TAU alone at 8 weeks. Patients with either remitted insomnia or depression showed higher QoL scores than non-remitted patients; scores approximated those within the normal range. Conclusions: For patients with insomnia in depression, adding CBT-I to TAU can produce substantive benefi ts in some aspects of QoL. Trial Registration: ClinicalTrials.gov Identifi er: NCT00610259, http://www.clinicaltrials.gov/ Keywords: Depressive disorder, sleep initiation and maintenance disorders, behavior therapy, quality of life Citation: Shimodera S; Watanabe N; Furukawa TA; Katsuki F; Fujita H; Sasaki M; Perlis ML. Change in quality of life after brief behavioral therapy for insomnia in concurrent depression: analysis of the effects of a randomized controlled trial.

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“…Concurrent insomnia and depression compounds illness severity and psychosocial difficulties (Sunderajan et al 2010;O'Brien et al 2011). Patients with insomnia are also at increased risk for suicidal behavior (Fawcett et al 1990;Agargun et al 1997), and this is true for adolescents, as well (Goldstein et al 2008).…”

Section: Introductionmentioning

confidence: 99%

Insomnia Moderates Outcome of Serotonin-Selective Reuptake Inhibitor Treatment in Depressed Youth

Emslie

Kennard

Mayes

et al. 2012

Journal of Child and Adolescent Psychopharmacology

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Objective: Insomnia is evident in the majority of youth with depression, and is associated with poorer outcomes. There are limited data on the impact of insomnia in response to acute treatment, which is particularly relevant with serotonin-selective reuptake inhibitors, given their tendency to worsen sleep architecture. Methods: Three hundred nine children and adolescents (ages 7-18 years) were randomized to fluoxetine (n = 157) or placebo (n = 152) for 8-9 weeks (Emslie et al.1997. Substantial insomnia at baseline was defined as a child's depression rating scale-revised [CDRS-R] sleep item ‡ 4. Outcome measures were CDRS-R, response, and remission. Results: Insomnia was reported in 172/309 (55.7%) youth, and was associated with higher depression severity and greater fatigue, suicidal ideation, physical complaints, and decreased concentration. While response rates were similar in those with or without insomnia overall (51.7% vs. 55.7%), there is a significant difference by age group. Among adolescents, those with insomnia were less likely to respond to fluoxetine (39.2%; 20/51) than those without (65.9%; 27/41; p = 0.013), while in children on fluoxetine, those with insomnia were more likely to respond to fluoxetine (69.4%; 25/36) than those without insomnia (41.4%; 12/29; p = 0.027). Insomnia did not impact the response to placebo in either age group. Within adolescents, the overall least squares means for CDRS-R total score (across the 8 weeks of treatment) were significantly different between those who had insomnia versus those who did not within the fluoxetine group ( Conclusions: While adolescents reporting substantial insomnia were less likely to respond to antidepressant treatment than those without insomnia, children were more responsive to fluoxetine when they had insomnia. Additional intervention targeting sleep disturbance may be warranted in adolescents.

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Insomnia in Patients With Depression: A STARD Report*

Cited by 136 publications

References 49 publications

Is Insomnia Associated With Suicidality in Stroke?

Is Insomnia Associated With Suicidality in Stroke?

Change in Quality of Life after Brief Behavioral Therapy for Insomnia in Concurrent Depression: Analysis of the Effects of a Randomized Controlled Trial

Insomnia Moderates Outcome of Serotonin-Selective Reuptake Inhibitor Treatment in Depressed Youth

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Insomnia in Patients With Depression: A STAR*D Report

Cited by 136 publications

References 49 publications

Is Insomnia Associated With Suicidality in Stroke?

Is Insomnia Associated With Suicidality in Stroke?

Change in Quality of Life after Brief Behavioral Therapy for Insomnia in Concurrent Depression: Analysis of the Effects of a Randomized Controlled Trial

Insomnia Moderates Outcome of Serotonin-Selective Reuptake Inhibitor Treatment in Depressed Youth

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Insomnia in Patients With Depression: A STARD Report*