Sleep disturbance in anxiety disorders

Abstract

Many patients suffering from the majority of anxiety disorders complain about their sleep by reporting difficulties in initiating and maintaining it. Polysomnographic studies have shown that, in comparison to normal subjects, the sleep of patients with panic disorder is characterized by longer sleep latency, increased time awake and reduced sleep efficiency. Sleep architecture is normal and there are no significant changes in REM sleep measures. Nocturnal panic attacks are non-REM-related events and occur without an obvious trigger in 18-45% of panic disorder patients. Regarding generalized anxiety disorder, the patients complain of 'trouble sleeping' in 60-70%, while polysomnography has shown increased sleep latency and decreased sleep continuity measures. The findings in REM sleep and sleep architecture generally do not show any aberration to exist. In patients with obsessive-compulsive disorder (OCD) and post-traumatic stress disorder (PTSD), results from the sleep laboratory do not seem to support the subjective complaints of poor sleep. The early reports of shortened REM latency in OCD could not be replicated by recent studies. A dysregulation of the REM sleep control system has been reported for patients with PTSD. Finally, no significant differences were found in all sleep parameters between social phobia patients and controls.

The impact of breast cancer treatments on sleep quality 1 year after cancer diagnosis

“…In Canada [9], a study conducted among cancer patients during the perioperative phase, in which some women had already been submitted to surgery, showed that 36.0% of those with breast cancer had insomnia syndrome (assessed using an adaptation of the Insomnia Interview Schedule). ALND axillary lymph node dissection, CTX chemotherapy, SLND sentinel lymph node dissection, 5-FU 5-fluorouracil a Defined as a score greater than or equal to 11 in the anxiety subscale of the Hospital Anxiety and Depression Scale; N = 501 due to missing data b Defined as a score greater than or equal to 11 in the depression subscale of the Hospital Anxiety and Depression Scale c Defined as a score greater than 5 in the Pittsburgh Sleep Quality Index d N = 481 due to missing data e Patients who had both mastectomy and breast-conserving surgery are reported as mastectomy and patients who had both ALND and SLNB are reported as ALND f All patients began this treatment during the first year of follow-up and remained under treatment at the 1-year follow-up evaluation Our findings of greater odds of poor sleep quality at baseline among those with anxiety and depression are consistent with the literature showing that anxiety and depression are associated with the presence of sleep disturbances in the general population [23][24][25] and in breast cancer patients [26,27]. In fact, insomnia symptoms are one of the diagnostic criteria for several mood and anxiety disorders [28].…”

“…The median time [percentile 25, percentile 75 (P25, P75)] between diagnosis (date of the first histological confirmation) and the baseline evaluation was 25 days (18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32).…”

Sleep Patterns, Work, and Strain among Young Students in Hospitality and Tourism

“…This was borne out by the results: decreased sleep quality, negative mood, and increased Insomnia Severity Index scores correlated with depressive and state and trait anxiety symptoms, whereas it seemed that sleep and working hours did not allow to provide further indications. Thus, our data fit well into the broad body of research in psychiatry which underlines the close relationship between sleep disorders and generalised 14) , specific 15) , or state-trait anxiety disorders 16) and depression 13) . Furthermore, our data provide evidence that the mere registration of sleep time is not sufficient to reliably indicate work-related sleep disturbances, confirming the findings of Nishikitani et al 2) .…”

“…Taken together, these findings hold that work-related psychological factors have adverse impact on sleep. It is interesting to note that despite well documented scientific evidence of the close association between sleep disorders and depression 13) , generalised 14) , specific 15) , or state-trait anxiety disorders 16) , the majority of research into sleep disturbances and working conditions has not taken into account psychiatric factors such as these (although for a notable exception see 10) ).…”

Sleep Disturbances in Traumatic Brain Injury: A Meta-Analysis

“…Anxiety and depression are both associated with reduced sleep quality, yet they are also associated with prolonged sleep onset latency. 43,44 Depression has also been associated with decreased slow wave sleep and increased percentage of REM sleep. 40,41 In contrast, our analysis of patients with mild TBI revealed less REM sleep percentage relative to controls.…”