Associations of lifetime major depressive disorder and its subtypes with sleep characteristics: a polysomnographic study


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A Master's thesis.
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Master (thesis) (master)
Associations of lifetime major depressive disorder and its subtypes with sleep characteristics: a polysomnographic study
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Université de Lausanne, Faculté de biologie et médecine
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Major depressive disorder is a common psychiatric disorder that is frequently referred to as one single disorder, but can and should be divided into at least four different subtypes, namely the atypical, melancholic, combined and unspecified subtypes, which have shown differential associations with cardio-vascular risk factors. A common symptom as mentioned in the DSM-5 is sleep disturbance, which varies according to the subtype, atypical being characterized by hypersomnia and melancholic by insomnia. Those parameters and others are observable by the use of polysomnography in particular. Multiple studies have analyzed sleep in MDD subjects compared to controls, but didn’t separate MDD into subtypes and only observed current MDD episode repercussions on sleep. To our knowledge, no study has yet assessed lifetime MDD effects on sleep, where sleep is measured around the time of remission of an episode. Therefore, our goal was to assess the associations for sleep characteristics measured just before, during or after the remission of a depressive disorder, either for MDD taken as a whole and for the depression subtypes separately. Using CoLaus/PsyCoLaus data from the general population of Lausanne, 1971 subjects were selected: 1123 controls and 848 lifetime MDD subjects subtyped into 126 atypical MDD, 229 melancholic MDD and 493 unspecified MDD (combined and unspecified taken together). Different sleep parameters were measured using polysomnography, including total sleep time, sleep efficiency, time in REM sleep and others. Results showed that, after adjustments for age, sex, socio-economic status, psychoactive substances, anxiety disorders and psychotropic medication, none of the sleep parameters were found to be statistically different between depressive subjects and controls. Possible reasons could be that the mix of current and past MDD subjects may have normalized the results. Indeed, our results suggest that when the MDD episode is over, sleep goes back to its normal structure, meaning that current MDD results were normalized by past MDD results. Further studies still need to be done where MDD should be subdivided according to time since remission to observe if there is an evolution in the sleep structure back to normal and if so how.
subtype, depression, sleep, polysomnography
Create date
07/09/2020 11:38
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05/02/2021 7:26
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