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The Evolving Nexus of Sleep and Depression

Journal

AMERICAN JOURNAL OF PSYCHIATRY
Volume 178, Issue 10, Pages 896-902

Publisher

AMER PSYCHIATRIC PUBLISHING, INC
DOI: 10.1176/appi.ajp.2021.21080821

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Funding

  1. American Sleep Medicine Foundation
  2. Brain and Behavior Research Foundation
  3. Madison Education Partnership
  4. National Institute of Nursing Research
  5. National Institute on Aging, NIMH
  6. University of Illinois at Chicago Occupational and Environmental Health and Safety Education and Research Center - National Institute for Occupational Safety and Health

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Sleep disturbances and depression are closely connected, with insomnia being a modifiable risk factor for depression. Treating insomnia can help prevent depressive episodes, and identifying hidden sleep disorders can improve treatment outcomes for treatment-resistant depression. Additionally, sleep alterations can clarify the mechanisms of rapid-acting antidepressant therapies.
Sleep disturbances and depression are closely linked and share a bidirectional relationship. These interconnections can inform the pathophysiology underlying each condition. Insomnia is an established and modifiable risk factor for depression, the treatment of which offers the critical opportunity to prevent major depressive episodes, a paradigm-shifting model for psychiatry. Identification of occult sleep disorders may also improve outcomes in treatment-resistant depression. Sleep alterations and manipulations may additionally clarify the mechanisms that underlie rapid-acting antidepressant therapies. Both sleep disturbance and depression are heterogeneous processes, and evolving standards in psychiatric research that consider the transdiagnostic components of each are more likely to lead to translational progress at their nexus. Emerging tools to objectively quantify sleep and its disturbances in the home environment offer great potential to advance clinical care and research, but nascent technologies require further advances and validation prior to widespread application at the interface of sleep and depression.

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