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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by Phillipa on November 7, 2011, at 18:30:46
Kind of makes me laugh don't tell me they are just figuring this out? I really thought we and docs knew this already. Phillipa
Medscape Medical News from the:
American Psychiatric Association 2011 Institute on Psychiatric Services (APA-IPS)This coverage is not sanctioned by, nor a part of, the American Psychiatric Association.
From Medscape Medical News > Psychiatry
Anxiety, Comorbid Depression Linked to Frequent Insomnia
Barbara BoughtonAuthors and Disclosures
November 7, 2011 (San Francisco, California) A study on the sleep habits of more than 94,000 Americans in 16 states indicates that insomnia is often associated with anxiety disorders, as well as comorbid depression.
The preliminary findings of the cross-sectional study from the Centers of Disease Control and Prevention (CDC) were presented here at the American Psychiatric Association 2011 Institute on Psychiatric Services (APA-IPS).
The study, which assessed self-reported anxiety disorders and depression diagnoses, as well as frequency of insufficient sleep via a telephone survey during 2008, was undertaken to better understand the reasons Americans are not getting enough sleep, according to CDC psychiatric epidemiologist Daniel Chapman, PhD.
"We often associate depression with sleep disorders, but our survey indicates that the prevalence of self-reported anxiety is roughly equivalent to that of depression in people who have insomnia," Dr. Chapman told Medscape Medical News.
In the survey, participants were asked how frequently they did not get enough rest or sleep within the last month. A response of "14 or more days" was classified as "frequent insufficient sleep."
Of those patients who reported frequent insufficient sleep, 39.4% also had received a self-reported anxiety diagnosis from a physician or healthcare provider, and 37.9% had a diagnosis of depressive disorder.
Yet the prevalence of comorbid anxiety and depression was even greater, at 50.1%, among those participants who had recently suffered from insufficient sleep. Prevalence statistics in the CDC study were adjusted for age, sex, race and ethnicity, education, employment, and marital status.
"We were surprised at how widespread the reports of anxiety and sleep disturbance were, as well as those of combined anxiety, depression, and insomnia," said Dr. Chapman.
"There is some scientific literature on the effect that anxiety disorders have on sleep, but it is not as extensive as that for depressive disorders," he added.
Dr. Chapman noted that the CDC study was limited by the fact that both the psychiatric diagnoses and the frequency of insomnia were self-reported. However, the study does help provide some increased understanding of why Americans are not getting enough sleep, he added.
Although depression is more often associated with sleep disturbance than anxiety, it is also true that many patients with anxiety disorder complain of trouble falling asleep, commented Felicia K. Wong, MD, a psychiatrist at Kaiser Permanente in Los Angeles, California.
"For my patients with generalized anxiety disorder, bedtime is the time when they start to worry and ruminate. Their spiraling worried thoughts keep them awake and prevent them from sleeping," Dr. Wong told Medscape Medical News.
"The good news is that when antianxiety medication is prescribed, patients often get relief not only from their anxiety but also from sleep deprivation," she said.
Dr. Chapman and Dr. Wong have disclosed no relevant financial relationships.
American Psychiatric Association 2011 Institute on Psychiatric Services (APA-IPS): Abstract 5-29. Presented October 29, 2011.
Posted by jono_in_adelaide on November 7, 2011, at 20:08:12
In reply to Anxiety or Comorbid depression Linked to Insomnia, posted by Phillipa on November 7, 2011, at 18:30:46
Reminds me of a study conducted at a well respected major australian hospital - showing that a painkilling capsule containing tylenol, caffeine, codeine and a tranquiliser was more effective in releiving headache than tylenol alone....... I think anybody could have told them that and saved a million dollars.
Posted by Phillipa on November 7, 2011, at 20:36:14
In reply to Re: Anxiety or Comorbid depression Linked to Insomnia, posted by jono_in_adelaide on November 7, 2011, at 20:08:12
Yes why I posted it. I was like duh doesn't everyone know this? A study to determine anxiety or depression could cause sleep problems is ridiculous? Phillipa
Posted by floatingbridge on November 8, 2011, at 1:41:00
In reply to Re: Anxiety or Comorbid depression Linked to Insomnia » jono_in_adelaide, posted by Phillipa on November 7, 2011, at 20:36:14
Phillipa, this was pretty funny. Like a parody.
Jono, those capsules sound great. Are they OTC where you are? :-)
I love seeing our tax money at work.
Posted by 49er on November 8, 2011, at 4:54:03
In reply to Anxiety or Comorbid depression Linked to Insomnia, posted by Phillipa on November 7, 2011, at 18:30:46
Hi Phillipa,
As someone who is dealing with insomnia which is possibly related to nasal congestion, I think we have to be very careful about reports like this and assume that all insomnia is psychological.
Of course, if anyone isn't sleeping, they are going to be depressed. Kind of hard to function on lack of sleep on a daily basis.
And you're going to be anxious because you see your life slipping away due to not being able to sleep and get the necessary things done that you need to accomplish.
Please don't misunderstand me as I realize some cases of insomnia are definitely psychological. But I am really getting tired of everything being blamed on that.
And in case folks think I am ranting for no reason at all, I am reading a book called insomniac by Gayle Greene. Dr. Greene, who has suffered from insomnia for several years, does a great job in giving the perspective of the insomniac. It is not a how to book as she figured we already had enough of those tips.
Anyway, she has gone to several insomnia conferences and spoken to sleep researchers and has constantly mentioned how physical causes are rarely looked at and how easily everything is blamed on psychological reasons. It is fascinating and anger provoking at the same time.
Finally, as an FYI, when I woke up last week with clear sinuses thanks to a homeopathic nasal spray. I felt like a totally different person ready to take on the world. I assure you that was not a placebo effect.
Sadly, the effect didn't last and I am trying to see if other remedies work before I consult a doctor.
Anyway, I am starting to ramble so I will stop here.
Posted by floatingbridge on November 8, 2011, at 5:21:18
In reply to Re: Anxiety or Comorbid depression Linked to Insomnia » Phillipa, posted by 49er on November 8, 2011, at 4:54:03
Hey 49er,
If that was a rant, it was a very coherent one. I am very sorry about your ongoing sinusitis. A good friend has it, and I know from him how much it impacts his life on a daily basis.
I am being picky here, so bear with me. I would posit that many who are depressed or anxious are suffering from physical ailments that are not always psychological in origin. I do not draw a firm line between psychologically based
depression and somatically based depression. This are ongoing thoughts for myself. The researchers who ran the quoted study may have lumped depression and anxiety into the merely psychological, and that would be a questionable assumption.That you suffer from a physical ailment that some may attempt to psyhcologize, I imagine that could be frustrating
and even insulting.
Posted by Phillipa on November 8, 2011, at 18:15:38
In reply to Re: Anxiety or Comorbid depression Linked to Insomnia » 49er, posted by floatingbridge on November 8, 2011, at 5:21:18
Sleep apnea for many cause it. Some have sleep studies. Lots of causes for not sleeping. I sleep well now. Do take a smaller and smaller amt of a benzo doesn't seem to make a difference where it once did. Age I guess for me. Phillipa
Posted by 49er on November 9, 2011, at 5:56:15
In reply to Re: Anxiety or Comorbid depression Linked to Insomnia » 49er, posted by floatingbridge on November 8, 2011, at 5:21:18
Thanks FB for your kind words and understanding. Many times, when I am tired, I worry about how I come across in a post.
I don't want to celebrate prematurely but I felt like I got better sleep from my first night using the dehumidifer.
No, you're not being picky and I totally understand where you are coming from. Suffering is suffering no matter what the source.
My concern though is if the depression is from a physical cause or misdiagnosed, that could be very dangerous to someone's health.
Yeah, it is definitely insulting to psychpathologize something as psychological when that might not necessarily be the case.
That is diagnosis anchoring in the worst form possible.
> Hey 49er,
>
> If that was a rant, it was a very coherent one. I am very sorry about your ongoing sinusitis. A good friend has it, and I know from him how much it impacts his life on a daily basis.
>
> I am being picky here, so bear with me. I would posit that many who are depressed or anxious are suffering from physical ailments that are not always psychological in origin. I do not draw a firm line between psychologically based
> depression and somatically based depression. This are ongoing thoughts for myself. The researchers who ran the quoted study may have lumped depression and anxiety into the merely psychological, and that would be a questionable assumption.
>
> That you suffer from a physical ailment that some may attempt to psyhcologize, I imagine that could be frustrating
> and even insulting.
Posted by 49er on November 9, 2011, at 5:57:48
In reply to Re: Anxiety or Comorbid depression Linked to Insomnia, posted by Phillipa on November 8, 2011, at 18:15:38
> Sleep apnea for many cause it. Some have sleep studies. Lots of causes for not sleeping. I sleep well now. Do take a smaller and smaller amt of a benzo doesn't seem to make a difference where it once did. Age I guess for me. Phillipa
I am glad you are sleeping well Phillipa.
49er
Posted by SLS on November 9, 2011, at 7:30:14
In reply to Re: Anxiety or Comorbid depression Linked to Insomnia » Phillipa, posted by 49er on November 8, 2011, at 4:54:03
> Please don't misunderstand me as I realize some cases of insomnia are definitely psychological.
I don't understand what you mean by "psychological".
Would the insomnia that is intrinsic to some types of Major Depressive Disorder qualify as being psychological?
MDD becomes increasingly biologically-driven when the illness takes a chronic or recurrent course. As time passes, the onset and persistence of depressive episodes becomes autonomous and is no longer linked to psychosocial stress.
http://www.ncbi.nlm.nih.gov/pubmed/10910786
http://www.ncbi.nlm.nih.gov/pubmed/21334286
Is the depression described in these citations "psychological" according to your definition?
I don't have a problem with models of MDD and BD that incorporate the role of psychosocial stress in the onset of these illnesses. However, I am dismayed whenever it is declared that these illnesses are not biological in nature, especially in chronic and recurrent cases. Since most people who post on the Medication board of Psycho-Babble have been depressed chronically or recurrently, I don't think it is productive to categorize their illnesses as being psychological. I hope this was not your intention.
- Scott
Posted by SLS on November 9, 2011, at 8:05:58
In reply to Re: Anxiety or Comorbid depression Linked to Insomnia » 49er, posted by SLS on November 9, 2011, at 7:30:14
> http://www.ncbi.nlm.nih.gov/pubmed/21334286
In my haste to come up with citations, I failed to focus my attention on the entirety of this abstract after having read the introductory statements. Dr. Post's kindling theory has its detractors, but that there is a sensitization process is accepted in most circles. I haven't seen the entire paper to comment on its conclusions.
Here:
http://www.ncbi.nlm.nih.gov/pubmed/11282692
- Scott
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