Recent advances in sleep and depression

Abstract

Purpose of reviewThere is increasing interest in the connection between sleep disturbances and mood disorders. The purpose of this review is to summarize and evaluate current research on the role of sleep disturbance in the development of depression, as well as to describe recent advances in treatments that improve both sleep and depression symptoms. Recent findingsRelevant publications included in this review cover a wide range of topics related to sleep and depression. Data from large longitudinal studies suggest that insomnia and evening circadian preference are unique risk factors for depression. Depression treatment studies indicate poorer outcomes for those with comorbid sleep disturbances. A few recent trials of cognitive behavioral therapy for insomnia and triple chronotherapy in unipolar depression have shown promising results. SummarySleep disturbance is a modifiable risk factor in the development and maintenance of depression. In the context of current depression, although the data is mixed, some evidence suggests treating sleep disturbance can improve overall outcomes. Recent evidence also suggests that treating sleep disturbance may prevent the future depressive episodes.

Cortical signatures of sleep are altered following effective deep brain stimulation for depression

“…Overall, our findings are consistent with the observation that earlier, more consistent sleep patterns across nights [7–18,33] and a sleep architecture that favours the earlier occurrence of deeper NREM sleep stages [19–27] are associated with good outcomes in the treatment of depression. In previous reports on SCC DBS, sleep was one of the first symptoms to show improvement with treatment.…”

Cortical signatures of sleep are altered following effective deep brain stimulation for depression

“…Overall, our findings are consistent with the observation that earlier, more consistent sleep patterns across nights [ 7 – 18 , 33 ] and a sleep architecture that favors the earlier occurrence of deeper NREM sleep stages [ 19 – 27 ] are associated with good outcomes in the treatment of depression. In previous reports on SCC DBS, sleep was one of the first symptoms to show improvement with treatment.…”

“…We show that spindle density is increased in the were the case, a change in slow-wave power and/or stability would also be expected, but we found no evidence for this. Overall, our findings are consistent with the observation that earlier, more consistent sleep patterns across nights [7][8][9][10][11][12][13][14][15][16][17][18]33] and a sleep architecture that favors the earlier occurrence of deeper NREM sleep stages [19][20][21][22][23][24][25][26][27] are associated with good outcomes in the treatment of depression. In previous reports on SCC DBS, sleep was one of the first symptoms to show improvement with treatment.…”

“…This is an important gap in knowledge as disruption in sleep is an established symptom of major depressive disorder (MDD) [6]. The relationship between MDD and sleep disturbances is bidirectional [7][8][9][10][11][12][13][14], and sleep disorders predict poorer treatment outcomes and likelihood of relapse [15][16][17][18]. There is also evidence that sleep structure is altered in depression, with reduced occurrence of the deeper stages of NREM and therefore slowwave activity [19][20][21][22][23][24], especially during the earlier sleep cycles, and a decreased REM sleep latency.…”

The association of hypogonadism with depression and its treatments

“…difficulty initiating or maintaining sleep, with or without hypersomnolence, are common in depression, where insomnia prevalence exceeds 80% ( 27 ). Moreover, longitudinal studies suggest that insomnia is a risk factor for depression, as it is associated with depressive symptom severity, lower rates of remission, higher risk of relapse, suicidal thoughts and self-injury ( 28 ). On the other hand, sleep disturbances can impact testosterone concentrations and sexual symptoms.…”