Mental health antecedents of early midlife insomnia: evidence from a four-decade longitudinal study.

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Abstract

Insomnia is a highly prevalent condition that constitutes a major public health and economic burden. However, little is known about the developmental etiology of adulthood insomnia.

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Most cited references 64

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The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research

Daniel J. Buysse, Charles Reynolds III, Timothy H Monk … (1989)

Despite the prevalence of sleep complaints among psychiatric patients, few questionnaires have been specifically designed to measure sleep quality in clinical populations. The Pittsburgh Sleep Quality Index (PSQI) is a self-rated questionnaire which assesses sleep quality and disturbances over a 1-month time interval. Nineteen individual items generate seven "component" scores: subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. The sum of scores for these seven components yields one global score. Clinical and clinimetric properties of the PSQI were assessed over an 18-month period with "good" sleepers (healthy subjects, n = 52) and "poor" sleepers (depressed patients, n = 54; sleep-disorder patients, n = 62). Acceptable measures of internal homogeneity, consistency (test-retest reliability), and validity were obtained. A global PSQI score greater than 5 yielded a diagnostic sensitivity of 89.6% and specificity of 86.5% (kappa = 0.75, p less than 0.001) in distinguishing good and poor sleepers. The clinimetric and clinical properties of the PSQI suggest its utility both in psychiatric clinical practice and research activities.

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Sleep drives metabolite clearance from the adult brain.

Lulu Xie, Hongyi Kang, Qiwu Xu … (2013)

The conservation of sleep across all animal species suggests that sleep serves a vital function. We here report that sleep has a critical function in ensuring metabolic homeostasis. Using real-time assessments of tetramethylammonium diffusion and two-photon imaging in live mice, we show that natural sleep or anesthesia are associated with a 60% increase in the interstitial space, resulting in a striking increase in convective exchange of cerebrospinal fluid with interstitial fluid. In turn, convective fluxes of interstitial fluid increased the rate of β-amyloid clearance during sleep. Thus, the restorative function of sleep may be a consequence of the enhanced removal of potentially neurotoxic waste products that accumulate in the awake central nervous system.

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Insomnia as a predictor of depression: a meta-analytic evaluation of longitudinal epidemiological studies.

Chiara Baglioni, Gemma Battagliese, Bernd Feige … (2011)

In many patients with depression, symptoms of insomnia herald the onset of the disorder and may persist into remission or recovery, even after adequate treatment. Several studies have raised the question whether insomniac symptoms may constitute an independent clinical predictor of depression. This meta-analysis is aimed at evaluating quantitatively if insomnia constitutes a predictor of depression. PubMed, Medline, PsycInfo, and PsycArticles databases were searched from 1980 until 2010 to identify longitudinal epidemiological studies simultaneously investigating insomniac complaints and depressed psychopathology. Effects were summarized using the logarithms of the odds ratios for insomnia at baseline to predict depression at follow-up. Studies were pooled with both fixed- and random-effects meta-analytic models in order to evaluate the concordance. Heterogeneity test and sensitivity analysis were computed. Twenty-one studies met inclusion criteria. Considering all studies together, heterogeneity was found. The random-effects model showed an overall odds ratio for insomnia to predict depression of 2.60 (confidence interval [CI]: 1.98-3.42). When the analysis was adjusted for outliers, the studies were not longer heterogeneous. The fixed-effects model showed an overall odds ratio of 2.10 (CI: 1.86-2.38). The main limit is that included studies did not always consider the role of other intervening variables. Non-depressed people with insomnia have a twofold risk to develop depression, compared to people with no sleep difficulties. Thus, early treatment programs for insomnia might reduce the risk for developing depression in the general population and be considered a helpful general preventive strategy in the area of mental health care. Copyright © 2011 Elsevier B.V. All rights reserved.

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Author and article information

Journal

Journal ID (iso-abbrev): Sleep

Title: Sleep

ISSN (Electronic): 1550-9109

ISSN (Print): 0161-8105

Publication date (Electronic): Nov 01 2014

Volume: 37

Issue: 11

Affiliations

[1 ] Center for Developmental Science, University of North Carolina at Chapel Hill, Chapel Hill, NC ; Department of Psychology & Neuroscience, Duke University, Durham, NC ; Institute for Genome Sciences & Policy, Duke University, Durham, NC ; Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC.

[2 ] Department of Psychology, Goldsmiths, University of London, London, UK.

[3 ] Department of Psychology & Neuroscience, Duke University, Durham, NC ; Institute for Genome Sciences & Policy, Duke University, Durham, NC ; Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC ; Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King's College, London, UK.

[4 ] Department of Psychology & Neuroscience, Duke University, Durham, NC ; Institute for Genome Sciences & Policy, Duke University, Durham, NC ; Department of Psychiatry & Behavioral Sciences, Duke University Medical Center, Durham, NC.

[5 ] MRC Harwell, Harwell Science and Innovation Campus, Oxfordshire, UK.

[6 ] Dunedin Multidisciplinary Health and Development Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand.

Article

Publisher Item ID: sp-00022-14

DOI: 10.5665/sleep.4168

PMC ID: 4196060

PubMed ID: 25364072

SO-VID: 706057bc-a2f1-4730-bff3-666623679c66

History

Keywords: anxiety,depression,insomnia

Data availability:

Keywords: anxiety, depression, insomnia

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Mental health antecedents of early midlife insomnia: evidence from a four-decade longitudinal study.

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Most cited references 64

The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research

Sleep drives metabolite clearance from the adult brain.

Insomnia as a predictor of depression: a meta-analytic evaluation of longitudinal epidemiological studies.

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