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Poor sleep can lead to the development of depression, and depression can cause insomnia, hypersomnia, or obstructive sleep apnea. [58] [59] About 75% of adult patients with depression can present with insomnia. [60]
Late-life depression refers to depression occurring in older adults and has diverse presentations, including as a recurrence of early-onset depression, a new diagnosis of late-onset depression, and a mood disorder resulting from a separate medical condition, substance use, or medication regimen. [1]
Between 10% and 30% of adults have insomnia at any given point in time and up to half of people have insomnia in a given year. [8] [9] [10] About 6% of people have insomnia that is not due to another problem and lasts for more than a month. [9] People over the age of 65 are affected more often than younger people. [7]
Sleep specialists measure the patient's sleep onset and offset, dim light melatonin onset, and evaluate Horne-Ostberg morningness-eveningness questionnaire results. Sleep specialists may also conduct a polysomnography test to rule out other sleep disorders like narcolepsy. Age and family history of the patient is also taken into consideration. [2]
One factor that could explain this change in sleep architecture is a disruption in the circadian rhythm, which regulates sleep. [19] This disruption can lead to sleep disturbances. [19] Some studies show that people with Alzheimer's disease have a delayed circadian rhythm, whereas in normal aging, an advanced circadian rhythm is present. [19] [20]
Fifty percent of people will have another major depressive episode after the first. [3] However, the risk of relapse is decreased by taking antidepressant medications for more than 6 months. [3] Symptoms completely improve in six to eight weeks in 60% to 70% of patients. [33]
Some careers, such as over-the-road truck drivers, firefighters, law enforcement, nursing, can be suitable for both people with delayed sleep phase syndrome and people with the opposite condition, advanced sleep phase disorder, as these workers are needed both very early in the morning and also late at night. [54]
Sleep deprivation and light therapy both target the same brain neurotransmitter system and brain areas as antidepressant drugs, and are now used clinically to treat depression. [28] Light therapy, sleep deprivation and sleep time displacement (sleep phase advance therapy) are being used in combination quickly to interrupt a deep depression in ...
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