Self-reported sleep lengths ≥ 9 hours among Swedish patients with stress-related exhaustion: Associations with depression, quality of sleep and levels of fatigue.
BACKGROUND
Insomnia-type sleep disturbances are frequent among patients suffering from stress-related exhaustion disorder. However, clinical observations indicate that a subgroup suffer from sleep lengths frequently exceeding 9 hours, coupled with great daytime sleepiness.


OBJECTIVE
The aim of the present study was to investigate differences in socio-demographic variables, use of medications, sleep parameters, anxiety, depression and fatigue, between individuals with varying sleep lengths, in a sample of 420 Swedish patients (mean age 42 ± 9 years; 77% women) referred to treatment for exhaustion disorder. Patients were allocated to the groups: "never/seldom ≥ 9 hours" (n = 248), "sometimes ≥ 9 hours" (n = 115) and "mostly/always ≥ 9 hours" (n = 57), based on their self-rated frequency of sleep lengths ≥ 9 hours.


METHODS
The design was cross-sectional and data was collected by means of questionnaires at pre-treatment.


RESULTS
Univariate analyses showed that patients in the "mostly/always ≥ 9 hours" group were more often on sick leave, and reported more depression and fatigue, better sleep quality and more daytime sleepiness, than patients in the other groups. Multivariate analyses showed that these patients scored higher on measures of fatigue than the rest of the sample independently of gender, use of antidepressants, sick leave, depression and quality of sleep.


CONCLUSIONS
Patients suffering from exhaustion disorder and reporting excessive sleep seem to have a generally poorer clinical picture but better quality of sleep than their counterparts with shorter sleep lengths. The mechanisms underlying these differences, together with their prognostic value and implications for treatment remain to be elucidated in future studies.
Giorgio Grossi, Ph.D., Stress Research Institute, Stockholm University , Stockholm , and The Stress Clinic Foundation , Stockholm , Sweden.
Giorgio
G
Grossi
Kerstin
K
Jeding
Marie
M
Söderström
Walter
W
Osika
Maria
M
Levander
Aleksander
A
Perski
D000328:Adult; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis* / Q000453:epidemiology; D006970:Disorders of Excessive Somnolence / Q000175:diagnosis* / Q000453:epidemiology; D005221:Fatigue / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057566:Self Report / Q000592:standards*; D012894:Sleep Stages; D013315:Stress, Psychological / Q000175:diagnosis* / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors
Depression; Sleep; Stress; Stress-related exhaustion