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Sleep and Depression
Abstract
BACKGROUND: Of all the psychiatric disorders associated with insomnia, depression is the most common. It has been estimated that 90% of patients with depression complain about sleep quality. Since the first reports of short rapid eye movement (REM) latency in depressed patients and of the effect of sleep deprivation on depression in the 1970s, numerous sleep studies have provided extensive observations and theoretical hypotheses concerning the etiology and pathophysiology of depression. The aim of this review is to summarize knowledge regarding the relationships between sleep and depression. DATA SOURCES AND SELECTION: MEDLINE and PsycINFO searches of the literature published in English or French between 1964 and 2005 that examined the relationships between sleep disturbance and depression were conducted. Search terms used were depression, depressive disorder, affective disorder, mood disorders, seasonal affective disorder, sleep, sleep disorders, insomnia, REM, polysomnography, sleep deprivation, electroencephalography, PET, SPECT, and fMRI. DATA SYNTHESIS: Two hundred five papers were identified and selected and then integrated into the following categories: sleep architecture, antidepressive therapies, age- and gender-associated differences, functional imaging results, and sleep-related hypotheses explaining the pathophysiology of depression. CONCLUSION: Numerous studies provide findings indicating the remarkable relationship between sleep alterations and depression. Although the existing hypotheses are not likely to explain all aspects of the sleep alterations in depression, each may be worth being maintained for refinements of pathophysiologic models of depression as new data accumulate. Further research taking into account the heterogeneity of depressive disorder and linking the different areas of research is needed to develop more comprehensive theoretical models and new therapies for depression.
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“Furthermore, PTSD treatment does not often result in insomnia remission, (Zayfert & DeViva, 2004), yet mental health symptoms, particularly depression symptoms (Tsuno, Besset, & Ritchie, 2005; Wagley, Rybarczyk, Nay, Danish, & Lund, 2013), do improve following engagement in CBT-I.”
From Benefits of Cognitive Behavioral Therapy for Insomnia for Women Veterans with and without Probable Post-Traumatic Stress Disorder (2022) · cites this paper as Tsuno, Besset, & Ritchie, 2005
In the citing paper
“The strong association of depressive and insomnia symptoms is consistent with evidence supporting their high level of comorbidity [35, 62–65].”
In the citing paper
“Depressed subjects also show reductions in slow wave (stage 3/4) sleep, increases in rapid eye movement (REM) sleep, including a shorter latency to REM initiation, a protraction of the REM sleep period, and increases in REM density (Palagini et al., 2013; Riemann et al., 2001; Tsuno et al., 2005).”
From The role of inflammation in core features of depression: Insights from paradigms using exogenously-induced inflammation. (2018) · cites this paper as Tsuno et al., 2005
In the citing paper
“Depressed subjects also show reductions in slow wave (stage 3/4) sleep, increases in rapid eye movement (REM) sleep, including a shorter latency to REM initiation, a protraction of the REM sleep period, and increases in REM density (Palagini et al., 2013; Riemann et al., 2001; Tsuno et al., 2005).”
From The role of inflammation in core features of depression: Insights from paradigms using exogenously-induced inflammation. (2018) · cites this paper as Tsuno et al., 2005
In the citing paper
“Depressed subjects also show reductions in slow wave (stage 3/4) sleep, increases in rapid eye movement (REM) sleep, including a shorter latency to REM initiation, a protraction of the REM sleep period, and increases in REM density (Palagini et al., 2013; Riemann et al., 2001; Tsuno et al., 2005).”
From The role of inflammation in core features of depression: Insights from paradigms using exogenously-induced inflammation. (2018) · cites this paper as Tsuno et al., 2005
In the citing paper
“Hypersomnia can also accompany depression, though it is somewhat less common (Garvey et al., 1984; Tsuno et al., 2005).”
From The role of inflammation in core features of depression: Insights from paradigms using exogenously-induced inflammation. (2018) · cites this paper as Tsuno et al., 2005
In the citing paper
“Depressed subjects also show reductions in slow wave (stage 3/4) sleep, increases in rapid eye movement (REM) sleep, including a shorter latency to REM initiation, a protraction of the REM sleep period, and increases in REM density (Palagini et al., 2013; Riemann et al., 2001; Tsuno et al., 2005).”
From The role of inflammation in core features of depression: Insights from paradigms using exogenously-induced inflammation. (2018) · cites this paper as Tsuno et al., 2005
In the citing paper
“Depressed subjects also show reductions in slow wave (stage 3/4) sleep, increases in rapid eye movement (REM) sleep, including a shorter latency to REM initiation, a protraction of the REM sleep period, and increases in REM density (Palagini et al., 2013; Riemann et al., 2001; Tsuno et al., 2005).”
From The role of inflammation in core features of depression: Insights from paradigms using exogenously-induced inflammation. (2018) · cites this paper as Tsuno et al., 2005
In the citing paper
“However, exogenously-induced inflammation using both endotoxin and IFN-α also led to a suppression of REM sleep (Mullington et al., 2000; Raison et al., 2010), which is the opposite of changes observed in depressed patients (Palagini et al., 2013; Riemann et al., 2001; Tsuno et al., 2005).”
From The role of inflammation in core features of depression: Insights from paradigms using exogenously-induced inflammation. (2018) · cites this paper as Tsuno et al., 2005
In the citing paper
“depressive illness is almost universally associated with disturbed sleep.91”
From Sleep Deprivation and Circadian Disruption (2015) · cites this paper as [91]
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Batheja, S., Yang, J., Liao, Y., Wengler, K., He, X., Ali, F., Rozensky, R., & DeLorenzo, C. (2026) · Journal of Affective Disorders · doi:10.1016/j.jad.2025.121076 · Cited by 1
Camargo, M. J. G., Felício, L. F. F., Schuch, F. B., Tornquist, D., Deslandes, A. C., Zanetti, A. C. G., Pires, D. A., da Silva, D. R. P., de Jesus‐Moraleida, F. R., Moura, H. F., et al. (2026) · Mental health and physical activity · doi:10.1016/j.mhpa.2025.100750 · Cited by 1
Metadata
- Authors
- Tsuno, N., Besset, A., & Ritchie, K.
- Affiliations
- Inserm (FR)
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2005-10-15
- Volume
- 66
- Issue
- 10
- Pages
- 1254-1269
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W2134977136
- Cited by
- 1,084
- References
- 0
- Citations by year
- 2026: 31 · 2025: 59 · 2024: 83 · 2023: 77 · 2022: 82 · 2021: 77 · 2020: 70 · 2019: 70 · 2018: 55 · 2017: 48 · 2016: 60 · 2015: 65 · 2014: 46 · 2013: 51 · 2012: 40
- FWCI
- 31.41
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Keywords
- depression, sleep disorders, insomnia, REM latency, sleep architecture, sleep deprivation, antidepressant treatment, seasonal affective disorder, gender differences, age differences, neuroimaging of depression, depression pathophysiology
- MeSH terms
- Adrenocorticotropic Hormone, Age Factors, Depressive Disorder, Diagnosis, Differential, Humans, Hydrocortisone, Magnetic Resonance Imaging, Sex Factors, Sleep Wake Disorders, Growth Hormone-Releasing Hormone, Comorbidity, Tomography, Emission-Computed, Single-Photon, Positron-Emission Tomography
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