Sleep and quality of life in depression

Abstract

Major depression is a common disorder; nearly 10% of the population suffers from a depressive illness in any given year. There is a strong association between sleep disturbances and depression. The most common sleep disturbance associated with major depressive disorder is insomnia. The relationship between insomnia and depression is bidirectional in that insomnia is one of the symptoms of depression and chronic insomnia can be a risk factor for depression. Depression causes changes in sleep patterns and sleep quality. Depressed patients showed prolonged sleep latency, increased wakefulness during sleep, early morning awakening, decreased sleep efficiency, decreased amounts of slow wave sleep and rapid eye movement (REM) sleep abnormalities. Depression is currently one of the leading causes of disability in the world. There is a direct association between the severity of depression and the level of disability. Depression has a big impact on quality of life of patients. Studies have showed that patients with major depressive disorder have poorer quality of life than persons from the general population. Effects of depression on quality of life are equal to or greater than those of patients with chronic medical conditions. Untreated depression usually does not go away by itself and often gets worse with time and increases a person's risk of suicide; it is a fact that up to 15% of those who are clinically depressed die through suicide. Clinical depression is treatable with counseling and medication. The majority of people with depressive disorders improve when they receive appropriate treatment. Improvement in depressive symptoms during the treatment is related to improvement in the quality of life. Antidepressants are shown to improve quality of life. There are some tools for evaluating quality of life in depressive patients, today. These tools help us to assess improvement in depressive patients beyond the extent to which depression rating scales do. In clinical settings, quality of life instruments can show us when patients begin to feel benefits of antidepressant therapy. © 2008 Humana Press, Totowa, NJ.