Advances in the research of comorbid insomnia and depression: mechanisms, impacts, and interventions
Open accessAbstract
Insomnia and depression, both significantly impacting public health, are common psychosomatic illnesses that frequently co-occur in the same individual. Not only do these two conditions commonly co-occur, but they also exhibit a bidirectional link, where the existence of one may heighten the risk for the other. Latest research offers compelling evidence of significant overlap in biological, psychological, and sociological aspects in the comorbidity of insomnia and depression. Building on this, we aim to examine the pathophysiology of insomnia and depression, along with their comorbid mechanisms, encompassing biological routes (like genetics, HPA axis, immune-inflammatory activation, neuroendocrine regulation, microbiome alterations, and neural circuits integrating sleep and emotion regulation), as well as psychosocial routes. Consequently, proposing a self-perpetuating and mutually reinforcing “snowball effect” model of comorbid insomnia and depression, and examining corresponding preventative intervention strategies to rectify associated imbalances. Finally, this article encapsulates the challenges in this field of study and the directions for future research. Finally, the paper points out the limitations of current research (cross-sectional data being dominant, and the mechanism of multi-omics dynamics being unknown) and the future direction (longitudinal cohort combined with computational modeling to resolve temporal interactions), which will provide a theoretical basis for precision interventions.
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Insomnia symptoms, including sleep-onset difficulties, are transdiagnostic phenomena maintaining psychiatric disorders through shared cognitive and physiological mechanisms.
“Emerging evidence supports insomnia symptoms, including sleep-onset difficulties, as transdiagnostic phenomena maintaining psychiatric disorders through shared cognitive and physiological mechanisms [6,7].”
From Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice. (2026) · cites this paper as [7]
The “Complicated relations between insomnia and depression” section describes insomnia as a possible transdiagnostic phenomenon, and “Biological pathways” includes difficulty falling asleep among its symptoms. The “Psycho-sociological pathways” section describes shared biological and psychological mechanisms through which insomnia and depression may maintain each other, but does not establish that insomnia maintains psychiatric disorders generally. Page numbers were not provided in our copy. (LLM, conf=0.85)
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Flagged first, then by citations
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Cited by
Sorted by citations
Pre-Sleep Anxiety: Mechanisms and Therapeutic Approaches in Clinical Practice.
Song, S., Irfan, M., Tahir, Z., Garrison, K. A., & Ziskind, S. (2026) · Current Sleep Medicine Reports · doi:10.1007/s40675-026-00370-2
- Authors
- Gao, T., Xiang, H., Wu, Q. N., Zhu, L. S., Pei, W. J., Fu, W. J., & Chou, T. S.
- Affiliations
- Hunan University of Traditional Chinese Medicine (CN)
- Corresponding author
- Chou, Tian Shu
- ORCID
- Wu, Qian Nan
- Venue
- Frontiers in Psychiatry
- Publisher
- Frontiers Media SA
- Published
- 2025-03-26
- Volume
- 16
- Pages
- 1468212-1468212
- ISSN
- 1664-0640 (ISSN-L)
- PMC
- PMC11980635
- OpenAlex
- W4408888266
- Cited by
- 17
- References
- 108
- Citations by year
- 2026: 12 · 2025: 5
- FWCI
- 2.80
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Frontiers in Psychiatry (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National College Students Innovation and Entrepreneurship Training Program
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Keywords
- insomnia, depression, comorbidities, bidirectional relationship, pathophysiology, hypothalamic-pituitary-adrenal axis, gut microbiota, prevention interventions, precision intervention, psychosocial factors
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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