Elaine M Boland1, Kassondra Bertulis2, Shirley H Leong3, Michael E Thase4, Philip R Gehrman4. 1. Cpl. Michael J. Crescenz VA Medical Center, Philadelphia, PA, United States; Department of Psychiatry, The Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, United States. Electronic address: elaine.boland@va.gov. 2. Department of Psychology, Widener University, Philadelphia, PA, United States. 3. Department of Psychiatry, The Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, United States. 4. Cpl. Michael J. Crescenz VA Medical Center, Philadelphia, PA, United States; Department of Psychiatry, The Perelman School of Medicine of the University of Pennsylvania, Philadelphia, PA, United States.
Abstract
BACKGROUND: The presence of insomnia in the context of depression is linked to a number of poor outcomes including reduced treatment response, increased likelihood of relapse, and greater functional impairment. Given the frequent co-occurrence of depression and insomnia, research into systems and processes relevant to both disorders, specifically reward processing and circadian rhythm disruption, may help parse this complex comorbidity. METHODS: A pilot study was conducted on a sample of 10 veterans with clinically significant depression and insomnia symptoms. Participants completed objective (actigraphy) and subjective (sleep diary) assessments of sleep, self-reports of chronotype, and behavioral tasks assessing reward relevant effort before and after 6 sessions of Cognitive Behavioral Therapy for Insomnia. RESULTS: Insomnia and depression significantly improved following CBT-I. Subjective sleep parameters significantly improved with large effect sizes. Actigraphy results were nonsignificant, but effect sizes for sleep efficiency and onset latency were in the medium range. Chronotype shifted significantly toward morningness following CBT-I, and an earlier chronotype at baseline was associated with increased reward effort following treatment. Changes in chronotype, depression and insomnia were not associated with changes in effort. LIMITATIONS: Findings are limited by small sample size and lack of randomized control group. CONCLUSIONS: Findings should be interpreted as hypothesis generating in the service of furthering research aimed at uncovering potential mechanisms underlying the depression/insomnia comorbidity. Analyses of sleep data in extant datasets of reward processing impairments in depression as well as original projects aimed at exploring potential sleep, circadian rhythm, and reward interactions in depression are encouraged. Published by Elsevier B.V.
BACKGROUND: The presence of insomnia in the context of depression is linked to a number of poor outcomes including reduced treatment response, increased likelihood of relapse, and greater functional impairment. Given the frequent co-occurrence of depression and insomnia, research into systems and processes relevant to both disorders, specifically reward processing and circadian rhythm disruption, may help parse this complex comorbidity. METHODS: A pilot study was conducted on a sample of 10 veterans with clinically significant depression and insomnia symptoms. Participants completed objective (actigraphy) and subjective (sleep diary) assessments of sleep, self-reports of chronotype, and behavioral tasks assessing reward relevant effort before and after 6 sessions of Cognitive Behavioral Therapy for Insomnia. RESULTS:Insomnia and depression significantly improved following CBT-I. Subjective sleep parameters significantly improved with large effect sizes. Actigraphy results were nonsignificant, but effect sizes for sleep efficiency and onset latency were in the medium range. Chronotype shifted significantly toward morningness following CBT-I, and an earlier chronotype at baseline was associated with increased reward effort following treatment. Changes in chronotype, depression and insomnia were not associated with changes in effort. LIMITATIONS: Findings are limited by small sample size and lack of randomized control group. CONCLUSIONS: Findings should be interpreted as hypothesis generating in the service of furthering research aimed at uncovering potential mechanisms underlying the depression/insomnia comorbidity. Analyses of sleep data in extant datasets of reward processing impairments in depression as well as original projects aimed at exploring potential sleep, circadian rhythm, and reward interactions in depression are encouraged. Published by Elsevier B.V.
Authors: Sonia Ancoli-Israel; Roger Cole; Cathy Alessi; Mark Chambers; William Moorcroft; Charles P Pollak Journal: Sleep Date: 2003-05-01 Impact factor: 5.849
Authors: Mindy Engle-Friedman; Suzanne Riela; Rama Golan; Ana M Ventuneac; Christine M Davis; Angela D Jefferson; Donna Major Journal: J Sleep Res Date: 2003-06 Impact factor: 3.981
Authors: Gabriel S Dichter; Jennifer N Felder; Christopher Petty; Joshua Bizzell; Monique Ernst; Moria J Smoski Journal: Biol Psychiatry Date: 2009-09-02 Impact factor: 13.382
Authors: Chloe C Boyle; Joshua H Cho; Naomi I Eisenberger; Richard E Olmstead; Dominique Piber; Nina Sadeghi; Masih Tazhibi; Michael R Irwin Journal: Neuropsychopharmacology Date: 2020-06-16 Impact factor: 8.294