Insomnia as a Precipitating Factor in New Onset Mental Illness: a Systematic Review of Recent Findings

Abstract

A literature yielded 1859 unique articles meeting search criteria were identified; 16 articles met all selection criteria and reviewed with some studies reporting on more than one mental health outcome. Overall, the review supports the hypothesis that insomnia is a predictor of subsequent mental illness. The evidence is strongest for an insomnia-depression relationship. The new studies identified and reviewed add to a modest number of publications supporting a prospective role of insomnia in new onset mental illness in three areas: anxiety disorders, bipolar disorder, and suicide. The few selected new studies focused on SUD were mixed, and no studies focused on PTSD were identified that met the selection criteria. Treatment of insomnia may also be a preventive mental health strategy.

Sleep and Migraine: Assessment and Treatment of Comorbid Sleep Disorders

“…Controlled trials demonstrated improvements in chronic migraine frequency following behavioral sleep treatment. The treatment group did exhibit a decrease in nighttime awakenings but all headache endpoints were equal to placebo, including [76][77][78] Insomnia and/or daytime sleepiness are symptoms of mood and anxiety disorders as well as chemical dependencies. Using a rigorous statistical approach and pooling evidence from the 2 controlled trials that each employed 1.5 hours of therapist contact (either one 90-minute 71 or three 30-minute treatment sessions 70 ), Smitherman and colleagues determined headache frequency was reduced at 6-8 week follow-up in the behavioral sleep treatment group 6.2 fewer headache days per month than the sham control group.…”

“…Psychiatric Comorbidity.-Psychiatric disorders are comorbid with both headache 74,75 and sleep disorders. [76][77][78] Insomnia and/or daytime sleepiness are symptoms of mood and anxiety disorders as well as chemical dependencies. 61 Screening may be warranted especially when either insomnia or hypersomnia is present.…”

The Sleep Condition Indicator: reference values derived from a sample of 200 000 adults

“…The importance of recognizing insomnia as a problem in its own right has been highlighted in the DSM‐5 recommendation that ‘insomnia disorder’ should be coded ‘whenever diagnostic criteria are met whether or not there is a co‐existing physical, mental or sleep disorder’ (American Psychiatric Association, ). In addition, mounting evidence suggests that chronic insomnia constitutes a risk factor for the development of physical and mental health problems (Khan and Aouad, ; Pigeon et al ., ). Similarly, insomnia is predictive of work disability (Sivertsen et al ., ), poorer quality of life (Kyle et al ., ) and higher societal costs (Leger and Bayon, ).…”

The key role of insomnia and sleep loss in the dysregulation of multiple systems involved in mood disorders: A proposed model

“…It is positively related to mood disorder severity, cognitive dysfunctions, levels of hopelessness, increased risk of substance abuse, aggressive and impulsive behaviours, emotional dysregulation and increased risk of suicidality (Baglioni, Spiegelhalder, Lombardo, & Riemann, 2010;Ritter et al, 2011;Boudebesse & Henry, 2012;Ritter et al, 2012;Conroy & Arnedt, 2014;Kamphuis, Dijk, Spreen, & Lancel, 2014;Schaffer et al, 2015;Kanady, Soehner, Klein, & Harvey, 2017;Ng et al, 2015;Woosley, Lichstein, Taylor, Riedel, & Bush, 2014;Woznica, Carney, Kuo, & Moss, 2015). Insomnia plays an important role in relapses and recurrences of mood disorders, it is an independent risk factor for mood disorders, and a frequent early sign occurring prior to both depressive and manic episodes (Baglioni et al, 2011;Ellis, Perlis, Gardani, Bastien, & Espie, 2014;Gruber et al, 2011;Kanady, Soehnera, & Harvey, 2015;Pigeon, Bishop, & Krueger, 2017;Ritter et al, 2015;Rumble et al, 2015;Sakurai, Suzuki, Yoshimura, Mimura, & Uchida, 2017). Recently, it has been shown that targeting insomnia may improve not only insomnia symptoms but favourably impacts on the trajectory of mood disorders (Franzen & Buysse, 2008;Geoffroy et al, 2017;Jansson-Fröjmark & Norell-Clarke, 2016;Manber et al, 2011) and, by reducing depressive symptoms, it may even prevent major depressive forms (Christensen et al, 2016).…”