Sleep disturbances: core symptoms of major depressive disorder rather than associated or comorbid disorders
Abstract
Depression is increasingly prevalent in Western countries. It has severe consequences and is associated with increased rates of disability, morbidity, and mortality. Despite numerous therapeutic options, a great number of depressed patients do not achieve full remission. In addition, despite good short-term outcomes, long-term therapeutic results remain disappointing and associated with a poor prognosis, raising significant concern in terms of public health. Impaired sleep - especially insomnia - may be at least partly responsible for this problem. Very close relationships between major depressive disorder (MDD) and sleep disorders have been observed. In particular, residual symptoms of sleep disturbance in a remitted patient may predict a relapse of the disease. However, most currently available antidepressants do not always take into consideration the sleep disturbances of depressed patients; some agents long used in clinical practice even appear to worsen them by their sleep-inhibiting properties. But some other new medications were shown to relieve early sleep disturbance in addition to alleviating other depression-related symptoms. This positive impact should promote compliance with medication and psychological treatments, and increase daytime performance and overall functioning. Complete remission of MDD appears therefore to depend on the relief of sleep disturbances, a core symptom of MDD that should be taken into consideration and treated early in depressed patients.
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Comorbidity and depressive symptoms are associated with sleep.
“Our multivariable adjusted models suggest that comorbidity and depressive symptoms are associated with sleep, as reported before [47].”
From Association between lunar phase and sleep characteristics (2014) · cites this paper as [47]
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- Authors
- Mendlewicz, J.
- Affiliations
- Université Libre de Bruxelles (BE)
- Corresponding author
- Mendlewicz, Julien
- ORCID
- Mendlewicz, Julien
- Venue
- The World Journal of Biological Psychiatry
- Publisher
- Informa UK Limited
- Published
- 2009-01
- Volume
- 10
- Issue
- 4
- Pages
- 269-275
- ISSN
- 1562-2975 (ISSN-L)
- 1814-1412
- OpenAlex
- W2140661724
- Cited by
- 143
- References
- 50
- Citations by year
- 2026: 2 · 2025: 16 · 2024: 5 · 2023: 11 · 2022: 8 · 2021: 9 · 2020: 5 · 2019: 12 · 2018: 2 · 2017: 9 · 2016: 9 · 2015: 1 · 2014: 7 · 2013: 13 · 2012: 17
- FWCI
- 1.68
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The World Journal of Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Dépôt institutionnel de l'Université libre de Bruxelles (Université Libre de Bruxelles) (submittedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- sleep disorders, insomnia, major depressive disorder, residual symptoms, recurrence prediction, antidepressants, medication adherence, remission, comorbid sleep disorders
- MeSH terms
- Acetamides, Adrenergic alpha-Antagonists, Anticonvulsants, Antidepressive Agents, Depressive Disorder, Major, Major Depressive Disorder, Drug Therapy, Combination, Histamine H1 Antagonists, Humans, Hypnotics and Sedatives, Sleep Initiation and Maintenance Disorders, Naphthalenes, Sleep Wake Disorders, Sleep Stages, Sleep, REM, Comorbidity, Secondary Prevention
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