Cooccurrence and bidirectional prediction of sleep disturbances and depression in older adults: Meta-analysis and systematic review

Bao, Yanping; Han, Ying; Ma, Jun; Wang, Ru-Jia; Shi, Le; Wang, Tongyu; He, Jianxun; Yue, Jing-Li; Shi, Jie; Tang, Xiangdong; Lü, Lin

doi:10.1016/j.neubiorev.2017.01.032

Cited by 179 publications

(126 citation statements)

References 108 publications

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“…A meta-analysis pooling all "sleep disturbances" (including insomnia, complaints of sleeping difficulties, and general poor sleep quality) found that they significantly increased the prospective risk for clinical depression or significant depres-sive symptoms (n=11, N=16,108, RR=1.92, 95% CI: 1.60-2.30, I 2 =10.2%), with even greater risk following "persistent" sleep disturbances (n=4, N=3,602, RR=3.90, 95% CI: 2.77-5.48, I 2 =27.1%) 70 . There was little heterogeneity between studies.…”

Section: Sleeping Patterns and Risk Of Mental Disordersmentioning

confidence: 99%

A meta‐review of “lifestyle psychiatry”: the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders

et al. 2020

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There is increasing academic and clinical interest in how “lifestyle factors” traditionally associated with physical health may also relate to mental health and psychological well‐being. In response, international and national health bodies are producing guidelines to address health behaviors in the prevention and treatment of mental illness. However, the current evidence for the causal role of lifestyle factors in the onset and prognosis of mental disorders is unclear. We performed a systematic meta‐review of the top‐tier evidence examining how physical activity, sleep, dietary patterns and tobacco smoking impact on the risk and treatment outcomes across a range of mental disorders. Results from 29 meta‐analyses of prospective/cohort studies, 12 Mendelian randomization studies, two meta‐reviews, and two meta‐analyses of randomized controlled trials were synthesized to generate overviews of the evidence for targeting each of the specific lifestyle factors in the prevention and treatment of depression, anxiety and stress‐related disorders, schizophrenia, bipolar disorder, and attention‐deficit/hyperactivity disorder. Standout findings include: a) convergent evidence indicating the use of physical activity in primary prevention and clinical treatment across a spectrum of mental disorders; b) emerging evidence implicating tobacco smoking as a causal factor in onset of both common and severe mental illness; c) the need to clearly establish causal relations between dietary patterns and risk of mental illness, and how diet should be best addressed within mental health care; and d) poor sleep as a risk factor for mental illness, although with further research required to understand the complex, bidirectional relations and the benefits of non‐pharmacological sleep‐focused interventions. The potentially shared neurobiological pathways between multiple lifestyle factors and mental health are discussed, along with directions for future research, and recommendations for the implementation of these findings at public health and clinical service levels.

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Section: Sleeping Patterns and Risk Of Mental Disordersmentioning

confidence: 99%

A meta‐review of “lifestyle psychiatry”: the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders

et al. 2020

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“…One meta‐analysis suggested that sleep disturbances and depression tend to co‐occur in older adults. Furthermore, persistent sleep disturbances have been found to predict the incidence, relapse and worsening of depression in older adults (Bao et al, ). Given that older adults are more vulnerable to sleep problems, attention should be drawn to the potential interactions between sleep problems and depression in that population.…”

Section: Introductionmentioning

confidence: 99%

Intergenerational relationships and depressive symptoms among older adults in urban China: The roles of loneliness and insomnia symptoms

2020

Health Soc Care Community

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The prevalence of depressive symptoms in older Chinese adults has increased recently. Intergenerational relationships play an important role in the mental health conditions of older adults, especially in Chinese culture. Therefore, this study aims to unravel the complex connection between intergenerational relationships and depression, and to explore the potential mediating roles of loneliness and nighttime insomnia symptoms within that connection. A cross-sectional household survey was conducted in China with 2038 participants aged 65 years or above. Variables were measured using the Center for Epidemiologic Studies Short Depression Scale, the Intergenerational Relationship Quality Scale for Aging Chinese Parents (IRQS-AP), three nighttime insomnia symptoms extracted from the Insomnia Severity Index and the De Jong Gierveld Six-Item Loneliness Scale. The IRQS-AP includes four subdimensions: consensual-normative solidarity, structural-associational solidarity, affectual closeness and intergenerational conflicts. Path analyses were performed in Mplus to investigate regression coefficients and mediating effects. Results showed that three general intergenerational relationships (consensual-normative solidarity, affectual closeness and intergenerational conflicts) were significantly correlated with all mental health outcomes, including their symptoms of loneliness, insomnia and depression. A serial mediation model suggested that loneliness mediated the connection between those constructs of intergenerational relationships and depression, with an independent path to insomnia symptoms via loneliness. The proposed mediators fully mediated the effects of affectual closeness on depression. Nighttime insomnia symptoms alone mediated only the relationship between intergenerational conflicts and depression independently from paths involving depression. Removal of sleep item from CES-D did not affect the results of paths. Our findings highlight the importance of intergenerational relationships for mental health, especially for the mediating effects of loneliness and nighttime insomnia symptoms on the relationship between intergenerational relationships and depression. Effective mental health services for older adults can address their feelings of loneliness and sleep problems, especially for those who have a poor relationship with their adult children. K E Y W O R D S depression, intergenerational relationships, loneliness, nighttime insomnia symptoms | 1311 FU and JI

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“…In bipolar disorder (BD) they may occur in 30-60% of patients, but reported rates vary from 10% to 80% depending on definition and management of potential confounding factors such as pharmacological treatments ( Steinan et al, 2016a;2016b ). Sleep disturbances have been increasingly recognized as important predictors of relapse in both major depressive disorder (MDD) and BD ( Bao et al, 2017;Bromberger et al, 2016;Craig et al, 2000;Gershon et al, 2017;Sakurai et al, 2017 ). Most descriptive studies on depressed or BD subjects with sleep alterations have focused on insomnia or decreased need to sleep, while fewer studies explored the presence of hypersomnia and its associated clinical features, despite its reported prevalence in 17-78% of patients with BD depression ( Steinan et al, 2016b ).…”

Section: Introductionmentioning

confidence: 99%

The implications of hypersomnia in the context of major depression: Results from a large, international, observational study

Murru

Guiso

Barbuti

et al. 2019

European Neuropsychopharmacology

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According to the DSM-5, "reduction in the need for sleep" is the only sleep-related criteria for mixed features in depressive episodes. We aimed at studying the prevalence, clinical correlates and the role of hypersomnia in a sample of acutely depressed patients. Secondarily, we factors significantly increasing the odds of hypersomnia were studied. We conducted a posthoc analysis of the BRIDGE-II-Mix study. Variables were compared between patients with hypersomnia (SLEEP +) and with insomnia (SLEEP −) with standard bivariate tests. A stepwise backward logistic regression model was performed with SLEEP + as dependent variable. A total of 2514 subjects were dichotomized into SLEEP + (n = 423, 16.8%) and SLEEP − (n = 2091, 83.2%). SLEEP + had significant higher rates of obese BMI (p < 0.001), BD diagnosis (p = 0.027), severe BD (p < 0.001), lifetime suicide attempts (p < 0.001), lower age at first depression (p = 0.004) than SLEEP −. Also, SLEEP + had significantly poorer response to antidepressants (AD) such as (hypo)manic switches, AD resistance, affective lability, or irritability (all 0 < 0.005). Moreover, SLEEP + had significantly higher rates of mixed-state specifiers than SLEEP-(all 0 < 0.006). A significant contribution to hypersomnia in our regression model was driven by metabolic-related features, such as "current bulimia" (OR = 4.21) and "overweight/obese BMI (OR = 1.42)". Globally, hypersomnia is associated with poor outcome in acute depression. Hypersomnia is strongly associated with mixed features and bipolarity. Metabolic aspects could influence the expression of hypersomnia, worsening the overall clinical outcome. Along with commonly used screening tools, detection of hypersomnia has potential, costless discriminative validity in the differential diagnosis unipolar and bipolar depression.

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Cooccurrence and bidirectional prediction of sleep disturbances and depression in older adults: Meta-analysis and systematic review

Cited by 179 publications

References 108 publications

A meta‐review of “lifestyle psychiatry”: the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders

A meta‐review of “lifestyle psychiatry”: the role of exercise, smoking, diet and sleep in the prevention and treatment of mental disorders

Intergenerational relationships and depressive symptoms among older adults in urban China: The roles of loneliness and insomnia symptoms

The implications of hypersomnia in the context of major depression: Results from a large, international, observational study

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