Association of sleep-wake state discrepancy and depressive symptoms with restorative sleep in patients with depression

Abstract

Objective

One of the common symptoms of mood disorders is insomnia, and the recovery processes can be negatively impacted by a lack of restorative sleep. Although factors related to restorative sleep in healthy subjects have been investigated, evaluations of these factors in patients with depression have been rarely done. Patients with depression are known to have sleep-wake state discrepancy, which can further influence their restorative sleep beyond that associated with depressive symptoms. Thus, we investigated restorative sleep in depressed patients in our current study, and attempted to identify associated factors, with a particular focus on sleep-wake state discrepancy.

Methods

In the 91 participants evaluated in this cross-sectional study, all subjects filled out questionnaires on their symptoms prior to undergoing polysomnography (PSG). Sleep duration and restorative sleep were evaluated on the morning after the PSG. The association between restorative sleep and various factors was then examined using multiple regression analysis.

Results

A negative association with restorative sleep was found through multiple regression analysis for depressive symptoms (β = −0.055, p = 0.007), daytime sleepiness (β = −0.106, p = 0.020), and overestimation of wake after sleep onset (β = −0.006, p = 0.030).

Conclusions

By subjectively and objectively assessing sleep, addressing depressive symptoms, and implementing appropriate sleep hygiene, clinicians could be able to improve restorative sleep in depressed patients.