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

• Published in: Journal of cellular and molecular medicine Vol. 23; no. 4; pp. 2324 - 2332
• Main Authors: Fang, Hong, Tu, Sheng, Sheng, Jifang, Shao, Anwen
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01.04.2019; John Wiley and Sons Inc
• Subjects: Antidepressants; Antidepressive Agents - therapeutic use; bidirectional relation; Bipolar disorder; Circadian rhythm; depression; Depression - complications; Depression - drug therapy; Depression - physiopathology; Depressive Disorder, Major - complications; Depressive Disorder, Major - drug therapy; Depressive Disorder, Major - physiopathology; Humans; Hypnotics; Hypnotics and Sedatives - therapeutic use; mechanism; Mental depression; Mental disorders; Review; Reviews; Risk Factors; Sleep; Sleep disorders; sleep disturbance; Sleep Initiation and Maintenance Disorders - complications; Sleep Initiation and Maintenance Disorders - drug therapy; Sleep Initiation and Maintenance Disorders - physiopathology; Sleep Wake Disorders - complications; Sleep Wake Disorders - drug therapy; Sleep Wake Disorders - physiopathology; treatment; treatment; bidirectional relation; depression; sleep disturbance; mechanism
• ISSN: 1582-1838; 1582-4934; 1582-4934
• DOI: 10.1111/jcmm.14170

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.