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. 2023 Apr 14:327:207-216.
doi: 10.1016/j.jad.2023.01.114. Epub 2023 Feb 3.

The relationship between sleep disturbance and cognitive impairment in mood disorders: A systematic review

Oliver Pearson  1 , Nora Uglik-Marucha  2 , Kamilla W Miskowiak  3 , Scott A Cairney  4 , Ivana Rosenzweig  5 , Allan H Young  6 , Paul R A Stokes  6
Affiliations
Free article

The relationship between sleep disturbance and cognitive impairment in mood disorders: A systematic review

Oliver Pearson et al. J Affect Disord. .
Free article

Abstract

Background: Cognitive impairment experienced by people with bipolar disorders (BD) or major depressive disorder (MDD) is associated with impaired psychosocial function and poorer quality of life. Sleep disturbance is another core symptom of mood disorders which may be associated with, and perhaps worsen, cognitive impairments. The aim of this systematic review was to critically assess the relationship between sleep disturbance and cognitive impairment in mood disorders.

Methods: In this systematic review, relevant studies were identified using electronic database searches of PsychINFO, MEDLINE, Embase and Web of Science.

Findings: Fourteen studies were included; eight investigated people with BD, five investigated people with MDD, and one included both people with MDD and people with BD. One study was an intervention for sleep disturbance and the remaining thirteen studies used either a longitudinal or cross-sectional observational design. Ten studies reported a significant association between subjectively measured sleep disturbance and cognitive impairment in people with MDD or BD after adjusting for demographic and clinical covariates, whereas no such association was found in healthy participants. Two studies reported a significant association between objectively measured (actigraphy or polysomnography) sleep abnormalities and cognitive impairment in mood disorders. One study of cognitive behavioural therapy for insomnia modified for BD (CBTI-BD) found an association between improvements in sleep and cognitive performance in BD.

Interpretation: There is preliminary evidence to suggest a significant association between sleep disturbance and cognitive impairment in mood disorders. These findings highlight the need for further research of sleep disturbances and cognitive impairment in people with mood disorders.

Keywords: Bipolar disorder; Cognitive impairment; Hypersomnia; Insomnia; Major depressive disorder; Sleep disorder; Sleep disturbance.

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Conflict of interest statement

Conflict of interest OP, NUM, SAC and IR declare no competing interests. KWM has received consultancy fees from Lundbeck and Janssen-Cilag in the past three years. PRAS reports non-financial support from Janssen Research and Development LLC, personal fees and non-financial support from Frontiers in Psychiatry, personal fees from Allergan, a grant from H Lundbeck, grants and non-financial support from Corcept Therapeutics, outside the submitted work. AHY declares: Employed by King's College London; Honorary Consultant SLaM (NHS UK). Deputy Editor, BJPsych Open. Paid lectures and advisory boards for the following companies with drugs used in affective and related disorders: Astrazenaca, Eli Lilly, Lundbeck, Sunovion, Servier, Livanova, Janssen, Allegan, Bionomics, Sumitomo Dainippon Pharma, COMPASS. Consultant to Johnson & Johnson. Consultant to Livanova. Received honoraria for attending advisory boards and presenting talks at meetings organised by LivaNova. Principal Investigator in the Restore-Life VNS registry study funded by LivaNova. Principal Investigator on ESKETINTRD3004: “An Open-label, Long-term, Safety and Efficacy Study of Intranasal Esketamine in Treatment-resistant Depression”. Principal Investigator on “The Effects of Psilocybin on Cognitive Function in Healthy Participants”. Principal Investigator on “The Safety and Efficacy of Psilocybin in Participants with Treatment-Resistant Depression (P-TRD)”. UK Chief Investigator for Novartis MDD study MIJ821A12201. Grant funding (past and present): NIMH (USA); CIHR (Canada); NARSAD (USA); Stanley Medical Research Institute (USA); MRC (UK); Wellcome Trust (UK); Royal College of Physicians (Edin); BMA (UK); UBC-VGH Foundation (Canada); WEDC (Canada); CCS Depression Research Fund (Canada); MSFHR (Canada); NIHR (UK). Janssen (UK). No shareholdings in pharmaceutical companies.

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