The Role of Late Life Depressive Symptoms on the Trajectories of Insomnia Symptoms During Antidepressant Treatment

Overview

Journal J Psychiatr Res

Specialty Psychiatry

Date 2017 Oct 26

PMID 29069615

Citations 4

Authors

Marie Anne Gebara

John Kasckow

Stephen F Smagula

Elizabeth A DiNapoli

Jordan F Karp

Eric J Lenze

Benoit H Mulsant

Charles F Reynolds 3rd

Affiliations

Soon will be listed here.

Abstract

Objective: Sleep disturbances are common in late life depression; however, changes in insomnia symptoms during antidepressant treatment need to be characterized further. The objective of this study was two-fold: 1) to describe longitudinal trajectories of insomnia symptoms in older adults receiving antidepressant treatment and 2) to examine whether baseline depressive symptoms were associated with trajectories of sleep over time.

Methods: Data was obtained from 680 older adults (aged ≥ 60) with major depression who participated in one of two protocolized open-label antidepressant treatment clinical trials (Maintenance Therapies in Late Life Depression [MTLD-3]; Incomplete Response in Late Life Depression: Getting to Remission [IRL-GRey]). Depression (total score minus sleep items) and sleep (sum of sleep items) outcomes were derived from the Hamilton Depression Rating Scale in the MLTD-3 and Montgomery-Asberg Depression Rating Scale in the IRL-GRey.

Results: Both datasets identified 5 possible trajectories of insomnia symptoms with about half of the older adults having clinically significant baseline sleep disturbances and minimal improvement following a course of antidepressant treatment (i.e., sub-optimal sleep trajectory). Furthermore, across both datasets, worse baseline depression severity was associated with sub-optimal sleep trajectories.

Conclusion: In older adults receiving antidepressant treatment, those with clinically significant baseline sleep disturbances and greater depression severity may require adjunctive sleep-focused treatment to ameliorate sleep symptoms.

Citing Articles

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