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. 2021 Aug 9:12:716097.
doi: 10.3389/fneur.2021.716097. eCollection 2021.

Impact of Insomnia Symptoms on the Clinical Presentation of Depressive Symptoms: A Cross-Sectional Population Study

Yun Ho Choi  1 , Kwang Ik Yang  2 , Chang-Ho Yun  3 , Won-Joo Kim  4 , Kyoung Heo  5 , Min Kyung Chu  5
Affiliations

Impact of Insomnia Symptoms on the Clinical Presentation of Depressive Symptoms: A Cross-Sectional Population Study

Yun Ho Choi et al. Front Neurol. .

Abstract

Objective: Insomnia and depression are prevalent disorders that often co-occur. This study aimed to investigate the impact of clinically significant insomnia symptoms on the prevalence and clinical presentation of clinically significant depressive symptoms and vice versa. Methods: This study used data from the Korean Headache-Sleep Study (KHSS), a nationwide cross-sectional population-based survey regarding headache and sleep. Clinically significant insomnia symptoms were defined as Insomnia Severity Index (ISI) scores ≥ 10 and clinically significant depressive symptoms were defined as Patient Health Questionnaire-9 (PHQ-9) scores ≥ 10, respectively. We referred clinically significant insomnia symptoms and clinically significant depressive symptoms as insomnia symptoms and depressive symptoms, respectively. Results: Of 2,695 participants, 290 (10.8%) and 116 (4.3%) were classified as having insomnia and depressive symptoms, respectively. The prevalence of depressive symptoms was higher among participants with insomnia symptoms than in those without insomnia symptoms (25.9 vs. 1.7%, respectively, P < 0.001). Among participants with depressive symptoms, the PHQ-9 scores were not significantly different between participants with and without insomnia symptoms (P = 0.124). The prevalence of insomnia symptoms was significantly higher among participants with depressive symptoms than in those without depressive symptoms (64.7 vs. 8.3%, respectively, P < 0.001). The ISI scores were significantly higher among participants with insomnia and depressive symptoms than in participants with insomnia symptoms alone (P < 0.001). Conclusions: Participants with depressive symptoms had a higher risk of insomnia symptoms than did those without depressive symptoms. The severity of depressive symptoms did not significantly differ based on insomnia symptoms among participants with depressive symptoms; however, the severity of insomnia symptoms was significantly higher in participants with depressive symptoms than in those without depressive symptoms.

Keywords: clinical presentation; depression; epidemiology; insomnia; prevalence.

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Conflict of interest statement

MC was a site investigator for a multi-center trial sponsored by Otsuka Korea, Novartis, International AG, and Eli Lilly and Co. He functioned as an advisory member for Teva, and received lecture honoraria from Allergan Korea, Handok-Teva, and Yuyu Pharmaceutical Company over the past 24 months. He received grants from the Yonsei University College of Medicine (2018-32-0037) and National Research Foundation of Korea (2019R1F1A1053841). The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart depicting the participation of individuals in the Korean Headache-Sleep Study.
Figure 2
Figure 2
Prevalence of depressive symptoms in participants with insomnia symptoms and those without insomnia symptoms.
Figure 3
Figure 3
Prevalence of insomnia symptoms in participants with depressive symptoms and those without depressive symptoms.
See this image and copyright information in PMC

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