The course of insomnia symptoms during the acute treatment of major depressive disorder: A CAN-BIND-1 report

May 10, 2023Psychiatry research

Changes in insomnia symptoms during early treatment of major depression

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Abstract

In a study of 180 patients, remitters of major depressive disorder had significantly lower insomnia scores throughout 8 weeks of treatment with escitalopram.

Remission of depression was associated with lower scores for sleep-onset and mid-nocturnal insomnia as measured by the Quick Inventory Depressive Scale.
Remitters also had significantly better sleep quality scores as assessed by the Pittsburgh Sleep Quality Index.
The findings suggest that monitoring insomnia symptoms may be useful for predicting acute remission of depression during treatment.

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Despite considerable efforts to study the relationship between insomnia and depression, there is minimal research investigating whether insomnia symptoms change over time during a course of antidepressant pharmacotherapy. This study investigated the course of insomnia symptoms during the acute treatment of major depressive disorder (MDD) using a secondary analysis of data from MDD patients (N = 180) who were treated with open-label escitalopram (10-20 mg/day) for 8-weeks. Montgomery-Asberg Depression Rating Scale without sleep item (modified-MADRS) assessed depression and Self-reported Quick Inventory Depressive Scale (QIDS-SR) measured subjective sleep-onset, mid-nocturnal, and early-morning insomnia throughout 8-weeks of treatment. Pittsburgh Sleep Quality Index (PSQI) was used to assess subjective sleep quality, duration, onset latency, and efficiency throughout 8-weeks of treatment. Remission of depression was defined as modified-MADRS ≤10 at week-8. Mixed model repeated measures (MMRMs) were conducted with remission status as an independent variable and each sleep variable as a dependent variable. MMRMs demonstrated that remitters had significantly lower QIDS-SR sleep-onset and mid-nocturnal insomnia scores as well as a significantly lower PSQI sleep quality score than non-remitters throughout 8-weeks of treatment. Monitoring subjective sleep-onset and mid-nocturnal insomnia during the course of treatment with serotonergic antidepressants may be useful for predicting acute remission of depression.

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The course of insomnia symptoms during the acute treatment of major depressive disorder: A CAN-BIND-1 report

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