Subjective and Objective Measures of Hypersomnolence Demonstrate Divergent Associations with Depression among Participants in the Wisconsin Sleep Cohort Study

Plante, David T.; Finn, Laurel; Hagen, Erika W.; Mignot, Emmanuel; Peppard, Paul E.

doi:10.5664/jcsm.5694

Cited by 38 publications

(30 citation statements)

References 50 publications

(50 reference statements)

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“…In the clinical protocol, participants were allowed to sleep for 15 min after sleep onset during naps to assess for sleep onset rapid eye movement (REM) periods. Because prior cross-sectional analyses have demonstrated nearly identical associations between mean SOL on MSLT and depressive symptoms using either protocol, as well as previous reports that have shown preceding polysomnography has minimal effects on mean SOL on MSLT, results from both protocols were combined for these analyses (Plante et al, 2016; Wichniak et al, 2002). Mean SOL below 8 minutes averaged across the first four nap opportunities defined objective EDS in these analyses, consistent with current nosology (American Academy of Sleep Medicine, 2014).…”

Section: Methodsmentioning

confidence: 99%

“…In addition, a universal limitation of all prior studies has been reliance on self-report measures to assess EDS. The absence of objective measures of daytime sleepiness, such as the multiple sleep latency test (MSLT), is particularly important because the relationship between objectively quantified sleep propensity and subjective sleepiness is relatively modest (Punjabi et al, 2003), and prior cross-sectional analyses from our group have demonstrated that objective and subjective hypersomnolence measures have divergent associations with depression (Plante et al, 2016). Thus, this current study utilized data from the Wisconsin Sleep Cohort (WSC) Study to examine longitudinal associations of both subjective and objective hypersomnolence measures with depression using conditional logistic regression analyses.…”

Section: Introductionmentioning

confidence: 99%

“…Thus, this current study utilized data from the Wisconsin Sleep Cohort (WSC) Study to examine longitudinal associations of both subjective and objective hypersomnolence measures with depression using conditional logistic regression analyses. Based on prior cross-sectional data (Plante et al, 2016), we hypothesized that self-reported excessive daytime sleepiness and sleep duration would be associated with increased odds of depression longitudinally, and that increased physiological sleep propensity, as quantified by the MSLT, would be inversely related to development of depression.…”

Section: Introductionmentioning

confidence: 99%

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Longitudinal associations of hypersomnolence and depression in the Wisconsin Sleep Cohort Study

Plante

Finn

Hagen

et al. 2017

Journal of Affective Disorders

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Background Hypersomnolence is common in depression, however longitudinal associations of excessive daytime sleepiness (EDS), long habitual sleep duration, and objective sleep propensity with depressive symptomatology are not well established. Methods Data from adults participating in the Wisconsin Sleep Cohort Study who had multiple assessments at 4-year intervals were utilized in analyses. Conditional (intrasubject) logistic regression estimated the likelihood of development of depression and three primary hypersomnolence measures: subjective EDS [Epworth Sleepiness Scale (ESS) > 10], habitual sleep duration ≥9 hours/day, and increased physiological sleep propensity [multiple sleep latency test (MSLT) mean sleep latency < 8 minutes]. Results After adjusting for all covariates, the odds for development of depression were significantly increased 1.67-fold (95% CI 1.02-2.73, p=0.04) in participants who also developed subjective EDS. However, development of increased physiological sleep propensity on the MSLT was associated with a trend towards reduced odds for development of depression (odds ratio 0.50, 95% CI 0.24-1.06, p=0.07). No significant longitudinal association between excessive sleep duration and depression was observed. Limitations Depression was not verified by psychiatric interview and an objective measure of sleep duration was not utilized. Conclusions Our results demonstrate a significant longitudinal association between increased subjective EDS and depression. However, increased physiological sleep propensity on the MSLT was paradoxically marginally protective against the development of depression. Further research is indicated to determine the mechanism underling divergent effects of various aspects of hypersomnolence on the course of mood disorders.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Longitudinal associations of hypersomnolence and depression in the Wisconsin Sleep Cohort Study

Plante

Finn

Hagen

et al. 2017

Journal of Affective Disorders

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“…Plante et al [19] further reported that odds ratios for depression were higher in patients with high ESS scores, in contrast to findings obtained for MSLT scores, suggesting that subjective scale scores may be affected by events other than sleepiness. Moreover, Leclerc et al [20] reported that pre-intervention ESS scores were significantly lower when measured prior to therapeutic interventions for OSA syndrome than when measured via recall following CPAP therapy.…”

Section: Discussionmentioning

confidence: 43%

Comparison of Sleep Latency Measured by the Oxford Sleep Resistance Test and Simultaneous EEG in Japanese Patients

Hosokawa¹,

Nishijima²,

Kizawa³

et al. 2017

J Sleep Disord Ther

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Excessive daytime sleepiness (EDS) is observed in various pathological conditions associated with sleep disorders. However, objective methods for the assessment of EDS rely on complex electroencephalographic (EEG) recording and are impractical for use in general clinical practice. To address this issue, the Oxford Sleep Resistance Test (OSLER) has been developed for use in clinical practice overseas, though few studies have examined the reliability of the OSLER test for measuring sleep latency in Japanese patients. Thus, in the present study, we aimed to determine whether sleep latency measured via the OSLER test (SL OSLER ) is consistent with that measured via EEG (SL EEG ) in Japanese patients with obstructive sleep apnea (OSA). Seventeen Japanese men with OSA (mean age: 51.5 ± 9.8 years) underwent simultaneous OSLER and EEG testing a total of four times on the day following polysomnography evaluation. SL OSLER and SL EEG were compared, and the reliability of the former was analysed using Bland-Altman plots. Mean SL OSLER and SL EEG for all patients were 26.9 ± 11.6 and 25.7 ± 12.2 minutes, respectively. A significant positive correlation was observed between these measurements (p<0.0001, r=0.963). Moreover, the Epworth Sleepiness Scale (ESS) scores were not significantly correlated with either SL OSLER or SL EEG . Bland-Altman plot analysis revealed that 94% of the plotted SL OSLER or SL EEG measurements converged within a range of mean ± 1.96 SD. Our findings thus demonstrated that SL OSLER is consistent with SL EEG in Japanese patients with OSA.

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“…Suicide attempts are not only a severe health problem, but also contribute substantially to the economic burden (Kadotani et al 2014). Previous studies have further indicated that the severity of depression is associated with symptoms such as insomnia, daytime sleepiness, short sleep duration, and a reduction in productivity at work, even among undiagnosed individuals (Jha et al 2016;Penninx et al 2008;Plante et al 2016;Baglioni et al 2011;Nakada et al 2015). Therefore, in the present study, we aimed to analyze the association among depression, sleep quality, and quality of life using the Japanese version of the SCID-I/NP (First et al 2002), and to compare these findings with those obtained using self-reported scales, in an urban male working population in Japan in order to determine the most effective instrument for screening for depression.…”

Section: Introductionmentioning

confidence: 99%

Comparison of self-reported scales and structured interviews for the assessment of depression in an urban male working population in Japan: a cross-sectional survey

Kadotani

Arai

et al. 2017

Sleep Science Practice

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Background:The present study aimed to analyze the association among depression, sleep quality, and quality of life using the Japanese version of the Structured Clinical Interview for DSM-IV Axis I Disorders Non-Patient Edition (SCID-I/NP), and to compare these findings with those obtained using self-reported scales, in an urban male working population in Japan. Methods: The present study included 324 middle-aged participants (43.8 ± 8.37 years) (participation rate: 69.5%). The Japanese version of the SCID-I/NP was administered by a single physician. Self-reported scales, including the Zung SelfRating Depression Scale (SDS), Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Assessment (PSQI), and 36-item Short-Form Health Survey (SF-36) were used to assess depression, sleepiness, sleep quality, and quality of life, respectively. Participants were then divided into a major depressive disorder (MDD) and control group based on the results of structured interviews, following which self-reported scale scores were compared between the two groups. Results: A total of 24 participants met criteria for MDD based on responses during structured interviews (current: 4; past: 20). Patients with MDD did not report feeling sleepier than those without psychiatric disorders (controls) (ESS: P = 0.184), although they experienced slightly poorer sleep quality (PSQI: P = 0.052). In addition, participants of the MDD group exhibited lower SF-36 subscale scores for general health (P = 0.002), vitality (P < 0.001), social functioning (P < 0.001), role emotional (P = 0.004), and mental health (P < 0.001) domains, and higher SDS scores (P = 0.038) compared to controls. The area under the receiver (AUC) operating characteristic curve for the detection of MDD was 0.631 and 0.706 for the SDS and mental health subscales, respectively. Conclusions: Our findings indicate that patients with MDD exhibit slightly poorer sleep quality and significantly poorer quality of life compared to controls, and that the SF-36 may be used as an alternative to the SDS to screen for depression in an urban male working population in Japan.

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Subjective and Objective Measures of Hypersomnolence Demonstrate Divergent Associations with Depression among Participants in the Wisconsin Sleep Cohort Study

Abstract: A commentary on this article appears in this issue on page 467.

Cited by 38 publications

References 50 publications

Longitudinal associations of hypersomnolence and depression in the Wisconsin Sleep Cohort Study

Longitudinal associations of hypersomnolence and depression in the Wisconsin Sleep Cohort Study

Comparison of Sleep Latency Measured by the Oxford Sleep Resistance Test and Simultaneous EEG in Japanese Patients

Comparison of self-reported scales and structured interviews for the assessment of depression in an urban male working population in Japan: a cross-sectional survey

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