Sleep and depression - theory and practice.
BACKGROUND
Sleep disorders are particularly common in the primary care setting, and are intimately interlinked with depression.


OBJECTIVE
This article aims to review the relationship between sleep and depression, with an emphasis on the foundation and clinical salience of this relationship.


CONCLUSIONS
Depression is the most common cause of insomnia, and insomnia is highly prevalent in depression. This association has a well characterised physiological foundation. Sleep disorder in depression has prognostic and therapeutic implications. Residual insomnia after remission of depression is predictive of relapse, and prominent insomnia predicts a poorer treatment outcome in depression. Evidence based management involves integrating both pharmacological and behavioural strategies; the latter includes sleep hygiene and regulating diurnal rhythms.
Berk
Michael
M
Melbourne University, Barwon Health and the Geelong Clinic, Mental Health Research Institute, and Orygen Research Centre, Victoria. mikebe@barwonhealth.org.au
D000928:Antidepressive Agents / Q000627:therapeutic use; D001521:Behavior Therapy; D003863:Depression / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D006801:Humans; D011379:Prognosis; D007319:Sleep Initiation and Maintenance Disorders / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy
D000928:Antidepressive Agents