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. 2013 Sep;30(9):873-80.
doi: 10.1002/da.22064. Epub 2013 May 16.

Relationship between sleep disturbance and depression, anxiety, and functioning in college students

Maren Nyer  1 , Amy Farabaugh, Kiki Fehling, David Soskin, Daphne Holt, George I Papakostas, Paola Pedrelli, Maurizio Fava, Angela Pisoni, Ottavio Vitolo, David Mischoulon
Affiliations

Relationship between sleep disturbance and depression, anxiety, and functioning in college students

Maren Nyer et al. Depress Anxiety. 2013 Sep.

Abstract

Background: Sleep disturbance (SD) has complex associations with depression, both preceding and following the onset and recurrence of depression. We hypothesized that students with depressive symptoms with SD would demonstrate a greater burden of comorbid psychiatric symptoms and functional impairment compared to students with depressive symptoms without SD.

Methods: During a mental health screening, 287 undergraduate students endorsed symptoms of depression (Beck Depression Inventory [BDI] ≥ 13) and filled out the following self-report measures: demographic questionnaire, BDI, Anxiety Symptom Questionnaire-intensity and frequency (ASQ), Beck Hopelessness Scale (BHS), Beck Anxiety Inventory (BAI), Quality of Life Enjoyment and Satisfaction Questionnaire (QLESQ), and the Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire (CPFQ). SD was measured using the BDI sleep item #16 dichotomized (score 0: no SD; or score > 0: some SD).

Results: Students with depressive symptoms and SD (n = 220), compared to those without SD (n = 67), endorsed significantly more intense and frequent anxiety and poorer cognitive and physical functioning. Students with depressive symptoms with and without SD did not significantly differ in depressive severity, hopelessness, or quality of life.

Conclusions: College students with depressive symptoms with SD may experience a greater burden of comorbid anxiety symptoms and hyperarousal, and may have impairments in functioning, compared to students with depressive symptoms without SD. These findings require replication.

Keywords: anxiety; college students; depression; functioning; hopelessness; hyperarousal; mental health screening; quality of life; sleep.

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Conflict of interest statement

Conflict of interest

Maren Nyer, Ph.D., reports no financial relationships with commercial interests.

Amy Farabaugh, Ph.D., has received grants from Narsad, Kaplen, as well as a K-23 award through NIMH. She received honoraria for talks at the MGH Academy and the APA. She holds/held stocks Pfizer, Glazo, and Smith Klein.

Kiki Fehling, B.A. reports no financial relationships with commercial interests.

David Soskin, M.D. has received research support from Harvard Medical School, Kaplen Fellowship and PharmoRx. He has received honoraria for speaking and/or consulting with MGH Psychiatry Academy/Primedia and ClearView Healthcare Partners. Daphne Holt, MD, PhD reports no financial relationships with commercial interests.

George Papakostas, M.D., has served as a consult for Abbott, BMS, Brainsway, Cephalon, Dey Pharmaceuticals, Eli Lilly, Otsuka, PAMLAB, Ridge Diagnostics, Takeda, and Theracos. He receives honoraria from the above companies, in addition to Astra Zeneca, GSK, Lundbeck, Pfizer and Roche. He has received grants from Astra Zeneca, BMS, Forest, NIMH, PAMLAB, Pfizer, Ridge Diagnostics and Sunovion.

Paola Pedrelli, PhD reports no financial relationships with commercial interests.

Maurizio Fava, M.D., has received research support from Abbot; Alkermes; Aspect Systems; AstraZeneca; BioResearch; BrainCells; BMS; CeNeRx; Cephalon; Clinical Trials Solutions; Clintara; Covance; Covidien; Eli Lilly; ElMindA; EnVivo; Euthymics; Forest; Ganeden; GSK; Icon; i3 Innovus/Ingenix; J&J; Lichtwer; Lorex; NARSAD; NCCAM; NIDA; NIMH; Novartis; Organon; PamLab;Pfizer; Pharmavite®; Photothera; Roche; RCT Logic; Sanofi-Aventis; Shire; Solvay; Synthelabo; Wyeth-Ayerst. He has served as a consult for Abbott; Affectis; Alkermes; Amarin; Aspect; A-Z; Auspex; Bayer; Best Practice Project Management; BioMarin; Biovail; BrainCells; BMS; CeNeRx; Cephalon Clinical Trials Solutions; CNS Response; Compellis; Cypress; DiagnoSearch Life Sciences; Dinippon Sumitomo; Dov; Edgemont; Eisai; Eli Lilly; EnVivo; ePharmaSolutions; EPIX; Euthymics; Fabre-Kramer; Forest; GenOmind; GSK; Grunenthal; i3 Innovus/Ingenis; Janssen; Jazz; J&J R&D; Knoll; Labopharm; Lorex; Lundbeck; MedA-vante; Merck; MSI Methylation Sciences; Naurex; NeuralStem;Neuronetics; NextWave; Novartis; Nutrition 21; Orexigen; Organon; Otsuka; PamLab; Pfizer; PharmaStar; Pharmavite®; PharmoRx; Precision Human Biolaboratory; Prexa; Puretech Ventures; PsychoGenics; Psylin; Rexahn; Ridge; Roche; RCT Logic; Sanofi-Aventis; Sepracor; Servier; Schering-Plough; Solvay; Somaxon; Somerset; Sunovion; Supernus; Synthelabo; Takeda; Tal Medical; Tetragenex; TransForm; Transcept; Vanda. He has received honoraria for speaking and/or publishing with Adamed, Co.; Advanced Meeting Partners; APA; ASCP; A-Z; Belvoir Media Group; Boehringer Ingelheim GmbH; BMS; Cephalon; CME Institute/Physicians Postgraduate Press, Inc.; Eli Lilly; Forest; GSK; Imedex; MGH Psychiatry Academy/Primedia; MGH Psychiatry Academy/Reed Elsevier; Novartis; Organon; Pfizer; PharmaStar; United BioSource; Wyeth-Ayerst. He has a minority share in equity holdings at Compellis. He has patents for Sequential Parallel Comparison Design (SPCD) and patent application for a combination of azapirones and bupropion in Major Depressive Disorder (MDD) for research and licensing of SPCD with RCT Logic. He receives copyright royalties for the MGH Cognitive & Physical Functioning Questionnaire (CPFQ), Sexual Functioning Inventory (SFI), Antidepressant Treatment Response Questionnaire (ATRQ), Discontinuation-Emergent Signs & Symptoms (DESS), and SAFER; Lippincott, Williams & Wilkins; Wolkers Kluwer; and World Scientific Publishing Co. Pte. Ltd.

Angela Pisoni, BA reports no financial relationships with commercial interests.

Ottavio Vitolo, M.D., has received research support from Harvard Neurodiscovery Center and Harvard Medical School, Dupont-Warren Fellowship, Harvard Psychiatry Department, Clinical Investigator Training Program, Beth Israel Deaconess Medical Center and Harvard Medical School which was in part funded with an unrestricted grant from Pfizer, Inc. and Merck & Co., Inc. He has pending patents with Ginkgolide compounds, compositions, extracts and uses thereof, methods for treating mild cognitive impairment, and ATF4 as a therapeutic target in Alzheimer’s disease and other neurological disorders.

David Mischoulon, M.D., Ph.D., has received research support from the Bowman Family Foundation, Bristol-Myers Squibb Co., Cederroth, FisherWallace, Ganeden, Lichtwer Pharma, and Nordic Naturals. He has received honoraria for consulting, speaking, and writing from Pamlab, Bristol-Myers Squibb Co., Nordic Naturals. He has received royalties from Back Bay Scientific for PMS Escape, and from Lippincott Williams & Wilkins for published book “Natural Medications for Psychiatric Disorders: Considering the Alternatives.” No payment has exceeded $10,000.

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