The role of late life depressive symptoms on the trajectories of insomnia symptoms during antidepressant treatment

Marie Anne Gebara, John Kasckow, Stephen F. Smagula, Elizabeth A. DiNapoli, Jordan F. Karp, Eric J. Lenze, Benoit H. Mulsant, Charles F. Reynolds

Research output: Contribution to journalArticle

2 Scopus citations

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.

Original languageEnglish
Pages (from-to)162-166
Number of pages5
JournalJournal of Psychiatric Research
Volume96
DOIs
StatePublished - Jan 2018

Keywords

  • Aging
  • Antidepressant treatment
  • Depression
  • Sleep trajectories

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