Abstract
Objective
Insomnia and depression are closely related. However, few studies have investigated
whether certain insomnia symptoms differentially relate to certain depressive symptoms.
The present study aimed to examine relationship between specific types of insomnia
symptoms (sleep symptoms, daytime symptoms, and perception symptoms) and specific
symptoms of depression.
Design
Cross-sectional, observational study data from the Sleep, Health, Activity, Diet and
Environment and Social Factors (SHADES) Survey.
Setting
Community-level population.
Participants
A total of 1003 community-based adults aged 22–60 from the Philadelphia area.
Measurements
Insomnia symptoms were represented by scores of sleep symptoms, daytime symptoms and
perception symptoms, derived from the Insomnia Severity Index (ISI). Depression symptoms
were assessed with the items of the Patient Health Questionnaire 9 (PHQ-9).
Results
A Confirmatory Factor Analysis (CFA) supported the three-factor model based on ISI
data. Binary logistic regressions examined independent associations between the three
insomnia symptom types and individual depression symptoms. Sleep symptoms were more
strongly associated with physiological aspects of depressive symptoms (appetite symptoms,
psychomotor symptoms, and suicidal ideation). The daytime symptoms, on the other hand,
were significantly associated with almost all depressive symptoms, except for appetite.
Moreover, daytime symptoms were exclusively related to cognitive symptoms of depression
(eg, trouble concentrating). The perception symptoms were independently associated
with mood symptoms, tiredness, appetite, and judgment of oneself as a failure, but
not with psychomotor, cognitive and suicidal ideation symptoms.
Conclusion
Daytime symptoms and perception symptoms of insomnia were more strongly associated
with a full range of depressive symptoms than sleep symptoms. The sleep symptoms were
mainly associated with more physiological symptoms of depression, implicating more
biological mechanisms. Further research is needed regarding how these types of insomnia
symptoms differentially related to multiple health consequences.
Keywords
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Article info
Publication history
Published online: March 27, 2019
Accepted:
December 19,
2018
Received in revised form:
December 5,
2018
Received:
July 17,
2018
Identification
Copyright
© 2019 National Sleep Foundation. Published by Elsevier Inc. All rights reserved.
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