TY - JOUR
T1 - Poor Sleep is Common in Treatment-Resistant Late-life Depression and Associated With Poorer Antidepressant Response
T2 - Findings From the OPTIMUM Clinical Trial
AU - Mak, Michael S.B.
AU - Gebara, Marie Anne
AU - Lenze, Eric J.
AU - Blumberger, Daniel M.
AU - Brown, Patrick J.
AU - Cristancho, Pilar
AU - Flint, Alastair J.
AU - Karp, Jordan F.
AU - Lavretsky, Helen
AU - Miller, J. Philip
AU - Reynolds, Charles F.
AU - Roose, Steven P.
AU - Mulsant, Benoit H.
AU - Stahl, Sarah T.
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2025/1
Y1 - 2025/1
N2 - Background: Adults with treatment-resistant late-life depression (TRLLD) have high rates of sleep problems; however, little is known about the occurrence and change in sleep during pharmacotherapy of TRLLD. This analysis examined: (1) the occurrence of insufficient sleep among adults with TRLLD; (2) how sleep changed during pharmacotherapy; and (3) whether treatment outcomes differed among participants with persistent insufficient sleep, worsened sleep, improved sleep, or persistent sufficient sleep. Methods: Secondary analysis of data from 634 participants age 60+ years in the OPTIMUM clinical trial for TRLLD. Sleep was assessed using the sleep item from the Montgomery-Asberg Depression Rating Scale at the beginning (week-0) and end (week-10) of treatment. The analyses examined whether treatment outcomes differed among participants with persistent insufficient sleep, worsened sleep, improved sleep, or persistent sufficient sleep during depression treatment. Results: About half (51%, n = 323) of participants reported insufficient sleep at baseline. Both persistent insufficient sleep (25%, n = 158) and worsened sleep (10%, n = 62) during treatment were associated with antidepressant nonresponse. Participants who maintained sufficient sleep (26%, n = 164) or who improved their sleep (n = 25%, n = 158) were three times more likely to experience a depression response than those with persistent insufficient sleep or worsened sleep. Conclusion: Insufficient sleep is common in TRLLD and it is associated with poorer treatment response to antidepressants.
AB - Background: Adults with treatment-resistant late-life depression (TRLLD) have high rates of sleep problems; however, little is known about the occurrence and change in sleep during pharmacotherapy of TRLLD. This analysis examined: (1) the occurrence of insufficient sleep among adults with TRLLD; (2) how sleep changed during pharmacotherapy; and (3) whether treatment outcomes differed among participants with persistent insufficient sleep, worsened sleep, improved sleep, or persistent sufficient sleep. Methods: Secondary analysis of data from 634 participants age 60+ years in the OPTIMUM clinical trial for TRLLD. Sleep was assessed using the sleep item from the Montgomery-Asberg Depression Rating Scale at the beginning (week-0) and end (week-10) of treatment. The analyses examined whether treatment outcomes differed among participants with persistent insufficient sleep, worsened sleep, improved sleep, or persistent sufficient sleep during depression treatment. Results: About half (51%, n = 323) of participants reported insufficient sleep at baseline. Both persistent insufficient sleep (25%, n = 158) and worsened sleep (10%, n = 62) during treatment were associated with antidepressant nonresponse. Participants who maintained sufficient sleep (26%, n = 164) or who improved their sleep (n = 25%, n = 158) were three times more likely to experience a depression response than those with persistent insufficient sleep or worsened sleep. Conclusion: Insufficient sleep is common in TRLLD and it is associated with poorer treatment response to antidepressants.
KW - Aging
KW - geriatric mental health
KW - sleep
KW - sleep disturbance
UR - http://www.scopus.com/inward/record.url?scp=85202563882&partnerID=8YFLogxK
U2 - 10.1016/j.jagp.2024.07.020
DO - 10.1016/j.jagp.2024.07.020
M3 - Article
C2 - 39209616
AN - SCOPUS:85202563882
SN - 1064-7481
VL - 33
SP - 63
EP - 72
JO - American Journal of Geriatric Psychiatry
JF - American Journal of Geriatric Psychiatry
IS - 1
ER -