Prevalence and clinical correlates of co-occurring insomnia and hypersomnia symptoms in depression

J Affect Disord. 2014;167:93-7. doi: 10.1016/j.jad.2014.05.060. Epub 2014 Jun 6.

Abstract

Background: The aim was to examine the prevalence and consequences of co-occurring insomnia and hypersomnia symptoms in depressed adults drawn from a representative sample of the U.S. population.

Method: Data from 687 National Comorbidity Survey Replication (NCS-R) respondents meeting criteria for a major depressive episode (MDE) in the past year were included. Respondents completed clinical interviews that assessed 12-month DSM-IV disorders, impairment, mental health treatment, and depressive symptom severity. Outcomes were compared between respondents who experienced insomnia symptoms-only (N=404), hypersomnia symptoms-only (N=44), both insomnia and hypersomnia symptoms (N=184) and no sleep problems (N=55) during an MDE.

Results: Insomnia and hypersomnia symptoms co-occurred in 27.7% of respondents with past-year MDEs, most frequently in bipolar spectrum disorders and major depressive disorder with dysthymia. Similar to the insomnia-only group, respondents with co-occurring sleep disturbances had more severe depression, and higher rates of past-year impulse control disorders and suicide planning. Similar to the hypersomnia-only group, respondents with co-occurring sleep disturbances had higher rates of past-year drug use disorders and suicide attempts. Compared to the insomnia-only and no sleep problem groups, respondents with both sleep disturbances were more frequently in mental health treatment, seeing a general practitioner, and taking antidepressants.

Limitations: The NCS-R is cross-sectional and did not evaluate sleep disorder diagnoses.

Conclusions: Co-occurring insomnia and hypersomnia symptoms were associated with a more severe MDE. Further research is warranted to more fully understand the joint presentation of insomnia and hypersomnia in depression.

Keywords: Depression; Hypersomnia; Insomnia; Mood disorders.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Antidepressive Agents / administration & dosage
  • Antidepressive Agents / adverse effects
  • Comorbidity
  • Cross-Sectional Studies
  • Depression / complications
  • Depression / epidemiology*
  • Depressive Disorder, Major / complications
  • Depressive Disorder, Major / epidemiology*
  • Disorders of Excessive Somnolence / epidemiology*
  • Disorders of Excessive Somnolence / etiology
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Self Report
  • Severity of Illness Index
  • Sleep Initiation and Maintenance Disorders / epidemiology*
  • Sleep Initiation and Maintenance Disorders / etiology
  • Suicidal Ideation
  • Suicide, Attempted
  • United States / epidemiology
  • Young Adult

Substances

  • Antidepressive Agents