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The association between sleep pathology and depression: A cross-sectional study among adults in greece

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Theofanis Vorvolakos, Eleni Leontidou, Dimitrios Tsiptsios, Christoph Mueller, Aspasia Serdari, Aikaterini Terzoudi, Evangelia Nena, Konstantinos Tsamakis, Theodoros C. Constantinidis, Gregory Gregory Tripsianis

Original languageEnglish
Article number113502
JournalPsychiatry Research
PublishedDec 2020

King's Authors


A cross-sectional population based study was conducted in order to evaluate the potential association of sleep
characteristics with depression using self-reported questionnaires and taking into account several socio-demographic,
lifestyle and health related characteristics. 957 participants aged between 19 and 86 years old were
enrolled in our study. Depression symptoms were assessed using the Beck Depression Inventory. Participants
self-reported their daily sleep habits and filled in the Epworth Sleepiness Scale, Athens Insomnia Scale,
Pittsburgh Sleep Quality Index and Berlin Questionnaire. Overall prevalence of depression was 28.4%.
Depression symptoms were more prominent among minority groups. Subjects with depression reported shorter
sleep duration and had reduced sleep efficiency. In patients with depression mean sleep duration was reduced by
23 min and mean sleep efficiency by 4%. Patients with depression were at higher risk of insomnia, poor sleep
quality and obstructive sleep apnea, but not of excessive daytime sleepiness. Concerning insomnia subtypes,
depression was associated with difficulties maintaining sleep and early morning awakening, but not problems
initiating sleep. Sleep disturbances are highly prevalent in depression and our findings support early pharmacological
or cognitive behavioral interventions in order to address this key depression-associated symptom. Only
addressing problems initiating sleep might not be sufficient in depression.

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