The association between sleep pathology and depression: A cross-sectional study among adults in Greece. (December 2020) - Vorvolakos, Theofanis
Highlights: Cross-sectional population based study designed to evaluate the potential association of sleep characteristics with depression among adults in greece using self-reported questionnaires. Depression symptoms are more prominent among minority groups. Depression disorders are associated with shorter sleep duration and reduced sleep efficiency. Individuals with depression exhibit high prevalence of insomnia and poor sleep quality and high risk of obstructive sleep apnea. In contrast, they do not report excessive daytime sleepiness. Concerning insomnia subtypes, individuals with depression experience difficulties maintaining sleep and early morning awakening, but not problems initiating sleep. Abstract: A cross-sectional population based study was conducted in order to evaluate the potential association of sleep characteristics with depression using self-reported questionnaires and taking into account several socio-demographic, lifestyle and health related characteristics. 957 participants aged between 19 and 86 years old were enrolled in our study. Depression symptoms were assessed using the Beck Depression Inventory. Participants self-reported their daily sleep habits and filled in the Epworth Sleepiness Scale, Athens Insomnia Scale, Pittsburgh Sleep Quality Index and Berlin Questionnaire. Overall prevalence of depression was 28.4%. Depression symptoms were more prominent among minority groups. Subjects with depression reported shorter sleep duration and had reduced sleep efficiency. In patients with depression mean sleep duration was reduced by 23 min and mean sleep efficiency by 4%. Patients with depression were at higher risk of insomnia, poor sleep quality and obstructive sleep apnea, but not of excessive daytime sleepiness. Concerning insomnia subtypes, depression was associated with difficulties maintaining sleep and early morning awakening, but not problems initiating sleep. Sleep disturbances are highly prevalent in depression and our findings support early pharmacological or cognitive behavioral interventions in order to address this key depression-associated symptom. Only addressing problems initiating sleep might not be sufficient in depression.