Skip to main content
SpringerLink
Log in

Comorbid Sleep Disorders in Neuropsychiatric Disorders Across the Life Cycle

  • Geriatric Disorders (H Lavretsky, Section Editor)
  • Published:
Current Psychiatry Reports Aims and scope Submit manuscript

Abstract

The association between psychopathology and poor sleep has long been recognized. The current review focuses on the association between the most prevalent sleep disorders (insomnia, sleep-related breathing disorders and restless legs syndrome) and four major psychiatric disorders: alcohol dependence, schizophrenia, depression and anxiety disorders. Decreased total sleep time and increased sleep onset latency as measured by polysomnography as well an increase of the prevalence of insomnia has been reported in all of these psychiatric disorders. Furthermore, sleep disturbance is a risk factor for their development. Cognitive-behavioral therapy for insomnia has been shown to have a positive impact on both sleep and symptoms of depression and anxiety. Whether adequate treatment of sleep disorders can prevent the incidence of psychiatric disorders, remains to be investigated.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Borsboom D, Cramer AO, Schmittmann VD, et al. The small world of psychopathology. PLoS One. 2011;6:e27407.

    Article  PubMed  CAS  Google Scholar 

  2. • Harvey AG, Murray G, Chandler RA, Soehner A. Sleep disturbance as transdiagnostic: consideration of neurobiological mechanisms. Clin Psychol Rev. 2011;31:225–35. This review suggests that sleep disturbance is a mechanistically transdiagnostic process which is causally linked to various psychiatric disorders.

    Article  PubMed  Google Scholar 

  3. Edinger JD, Bonnet MH, Bootzin RR, et al. Derivation of research diagnostic criteria for insomnia: report of an American Academy of Sleep Medicine work group. Sleep. 2004;27:1567–96.

    PubMed  Google Scholar 

  4. Kyle SD, Morgan K, Espie CA. Insomnia and health-related quality of life. Sleep Med Rev. 2010;14:69–82.

    Article  PubMed  Google Scholar 

  5. Fortier-Brochu E, Beaulieu-Bonneau S, Ivers H, Morin CM. Insomnia and daytime cognitive performance: a meta-analysis. Sleep Med Rev. 2012;16:83–94.

    Article  PubMed  Google Scholar 

  6. Shekleton JA, Rogers NL, Rajaratnam SM. Searching for the daytime impairments of primary insomnia. Sleep Med Rev. 2010;14:47–60.

    Article  PubMed  Google Scholar 

  7. Buysse DJ, Thompson W, Scott J, et al. Daytime symptoms in primary insomnia: a prospective analysis using ecological momentary assessment. Sleep Med. 2007;8:198–208.

    Article  PubMed  Google Scholar 

  8. Kyle SD, Espie CA, Morgan K. “…Not just a minor thing, it is something major, which stops you from functioning daily”: quality of life and daytime functioning in insomnia. Behav Sleep Med. 2010;8:123–40.

    Article  PubMed  Google Scholar 

  9. Kierlin L, Olmstead R, Yokomizo M, et al. Diagnostic and Statistical Manual criteria for insomnia related impairment in daytime functioning: polysomnographic correlates in older adults. Sleep Med. 2012;13:958–60.

    Article  PubMed  Google Scholar 

  10. Riemann D, Perlis ML. The treatments of chronic insomnia: a review of benzodiazepine receptor agonists and psychological and behavioral therapies. Sleep Med Rev. 2009;13:205–14.

    Article  PubMed  Google Scholar 

  11. Morin CM, Bootzin RR, Buysse DJ, et al. Psychological and behavioral treatment of insomnia: update of the recent evidence (1998–2004). Sleep. 2006;29:1398–414.

    PubMed  Google Scholar 

  12. Irwin MR, Cole JC, Nicassio PM. Comparative meta-analysis of behavioral interventions for insomnia and their efficacy in middle-aged adults and in older adults 55+ years of age. Health Psychol. 2006;25:3–14.

    Article  PubMed  Google Scholar 

  13. Morin CM, Culbert JP, Schwartz SM. Nonpharmacological interventions for insomnia: a meta-analysis of treatment efficacy. Am J Psychiatry. 1994;151:1172–80.

    PubMed  CAS  Google Scholar 

  14. Young T, Palta M, Dempsey J, et al. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med. 1993;328:1230–5.

    Article  PubMed  CAS  Google Scholar 

  15. Allen RP, Picchietti D, Hening WA, et al. Restless legs syndrome: diagnostic criteria, special considerations, and epidemiology. A report from the restless legs syndrome diagnosis and epidemiology workshop at the National Institutes of Health. Sleep Med. 2003;4:101–19.

    Article  PubMed  Google Scholar 

  16. Mayer G, Jennum P, Riemann D, Dauvilliers Y. Insomnia in central neurologic diseases – occurrence and management. Sleep Med Rev. 2011;15:369–78.

    Article  PubMed  Google Scholar 

  17. Zanigni S, Calandra-Buonaura G, Grimaldi D, Cortelli P. REM behaviour disorder and neurodegenerative diseases. Sleep Med. 2011;12:S54–8.

    Article  PubMed  Google Scholar 

  18. Benca RM, Obermeyer WH, Thisted RA, Gillin JC. Sleep and psychiatric disorders. Arch Gen Psychiatry. 1991;49:651–68.

    Article  Google Scholar 

  19. Zhabenko N, Wojnar M, Brower KJ. Prevalence and correlates of insomnia in a polish sample of alcohol-dependent patients. Alcohol Clin Exp Res. 2012;36:1600–7.

    Article  PubMed  Google Scholar 

  20. Brower KJ, Krentzman A, Robinson EA. Persistent insomnia, abstinence, and moderate drinking in alcohol-dependent individuals. Am J Addict. 2011;20:435–40.

    Article  PubMed  Google Scholar 

  21. Crum RM, Ford DE, Storr CL, Chan YF. Association of sleep disturbance with chronicity and remission of alcohol dependence: data from a population-based prospective study. Alcohol Clin Exp Res. 2004;28:1533–40.

    Article  PubMed  Google Scholar 

  22. Brower KJ, Aldrich MS, Robinson EA, et al. Insomnia, self-medication, and relapse to alcoholis. Am J Psychiatry. 2001;158:399–404.

    Article  PubMed  CAS  Google Scholar 

  23. Brower KJ, Perron BE. Prevalence and correlates of withdrawal-related insomnia among adults with alcohol dependence: results from a national survey. Am J Addict. 2010;19:238–44.

    Article  PubMed  Google Scholar 

  24. Weissman MM, Greenwald S, Nino-Murcia G, Dement WC. The morbidity of insomnia uncomplicated by psychiatric disorders. Gen Hosp Psychiatry. 1997;19:245–50.

    Article  PubMed  CAS  Google Scholar 

  25. Gann H, Feige B, Hohagen F, et al. Sleep and the cholinergic rapid eye movement sleep induction test in patients with primary alcohol dependence. Biol Psychiatry. 2001;50:383–90.

    Article  PubMed  CAS  Google Scholar 

  26. Gillin JC, Smith TL, Irwin M, et al. Increased pressure for rapid eye movement sleep at time of hospital admission predicts relapse in nondepressed patients with primary alcoholism at 3-month follow-up. Arch Gen Psychiatry. 1994;51:189–97.

    Article  PubMed  CAS  Google Scholar 

  27. Feige B, Scaal S, Hornyak M, et al. Sleep electroencephalographic spectral power after withdrawal from alcohol in alcohol-dependent patients. Alcohol Clin Exp Res. 2007;31:19–27.

    Article  PubMed  Google Scholar 

  28. Klimkiewicz A, Bohnert AS, Jakobczyk A, et al. The association between insomnia and suicidal thoughts in adults treated for alcohol dependence in Poland. Drug Alcohol Depend. 2012;122:160–3.

    Article  PubMed  Google Scholar 

  29. Currie SR, Clark S, Hodgins DC, El-Guebaly N. Randomized controlled trial of brief cognitive-behavioural interventions for insomnia in recovering alcoholics. Addiction. 2004;99:1121–32.

    Article  PubMed  Google Scholar 

  30. Arnedt JT, Conroy D, Rutt J, et al. An open trial of cognitive-behavioral treatment for insomnia comorbid with alcohol dependence. Sleep Med. 2007;8:176–80.

    Article  PubMed  Google Scholar 

  31. Arnedt JT, Conroy DA, Armitage R, Brower KJ. Cognitive-behavioral therapy for insomnia in alcohol dependent patients: a randomized controlled pilot trial. Behav Res Ther. 2011;49:227–33.

    Article  PubMed  Google Scholar 

  32. Peppard PE, Austin D, Brown RL. Association of alcohol consumption and sleep disordered breathing in men and women. J Clin Sleep Med. 2007;3:265–70.

    PubMed  Google Scholar 

  33. Aldrich MS, Brower KJ, Hall JM. Sleep-disordered breathing in alcoholics. Alcohol Clin Exp Res. 1999;23:134–40.

    Article  PubMed  CAS  Google Scholar 

  34. Gann H, Feige B, Fasihi S, et al. Periodic limb movements during sleep in alcohol dependent patients. Eur Arch Psychiatry Clin Neurosci. 2002;252:124–9.

    Article  PubMed  Google Scholar 

  35. Schiavi RC, Stimmel BB, Mandeli J, White D. Chronic alcoholism and male sexual function. Am J Psychiatry. 1995;152:1045–51.

    PubMed  CAS  Google Scholar 

  36. Chouinard S, Poulin J, Stip E, Godbout R. Sleep in untreated patients with schizophrenia: a meta-analysis. Schizophr Bull. 2004;30:957–67.

    Article  PubMed  Google Scholar 

  37. Palmese LB, DeGeorge PC, Ratliff JC, et al. Insomnia is frequent in schizophrenia and associated with night eating and obesity. Schizophr Res. 2011;133:238–43.

    Article  PubMed  Google Scholar 

  38. •• Ruhrmann S, Schultze-Lutter F, Salokangas RK, et al. Prediction of psychosis in adolescents and young adults at high risk. Arch Gen Psychiatry. 2010;67:241–51. This multicenter study showed that sleep disturbance is a predictor of psychosis.

    Article  PubMed  Google Scholar 

  39. Chemerinski E, Ho BC, Flaum M, et al. Insomnia as a predictor for symptom worsening following antipsychotic withdrawal in schizophrenia. Compr Psychiatry. 2002;43:393–6.

    Article  PubMed  Google Scholar 

  40. Myers E, Startup H, Freeman D. Cognitive behavioural treatment of insomnia in individuals with persistent persecutory delusions: a pilot trial. J Behav Ther Exp Psychiatry. 2011;42:330–6.

    Article  PubMed  Google Scholar 

  41. Wulff K, Dijk DJ, Middleton B, et al. Sleep and circadian rhythm disruption in schizophrenia. Br J Psychiatry. 2012;200:308–16.

    Article  PubMed  Google Scholar 

  42. Bromundt V, Köster M, Georgiev-Kill A, et al. Sleep-wake cycles and cognitive functioning in schizophrenia. Br J Psychiatry. 2011;198:269–76.

    Article  PubMed  Google Scholar 

  43. Waters F, Hanken K, Rock D. Sleep-disordered breathing in schizophrenia: an audit. Schizophr Res. 2013;143:393–4.

    Article  PubMed  Google Scholar 

  44. Ancoli-Israel S, Martin J, Jones DW. Sleep-disordered breathing and periodic limb movements in sleep in older patients with schizophrenia. Biol Psychiatry. 1999;45:1426–32.

    Article  PubMed  CAS  Google Scholar 

  45. Pinninti NR, Mago R, Townsend J, Doghramji K. Periodic restless legs syndrome associated with quetiapine use: a case report. J Clin Psychopharmacol. 2005;25:617–8.

    Article  PubMed  Google Scholar 

  46. Wetter TC, Brunner J, Bronisch T. Restless legs syndrome probably induced by risperidone treatment. Pharmacopsychiatry. 2002;35:109–11.

    Article  PubMed  CAS  Google Scholar 

  47. Kraus T, Schuld A, Pollmächer T. Periodic leg movements in sleep and restless legs syndrome probably caused by olanzapine. J Clin Psychopharmacol. 1999;19:478–9.

    Article  PubMed  CAS  Google Scholar 

  48. Wamsley EJ, Tucker MA, Shinn AK, et al. Reduced sleep spindles and spindle coherence in schizophrenia: mechanisms of impaired memory consolidation? Biol Psychiatry. 2012;71:154–61.

    Article  PubMed  Google Scholar 

  49. Ferrarelli F, Peterson MJ, Sarasso S, et al. Thalamic dysfunction in schizophrenia suggested by whole-night deficits in slow and fast spindles. Am J Psychiatry. 2010;167:1339–48.

    Article  PubMed  Google Scholar 

  50. Manoach DS, Cain MS, Vangel MG, et al. A failure of sleep-dependent procedural learning in chronic, medicated schizophrenia. Biol Psychiatry. 2004;56:951–6.

    Article  PubMed  Google Scholar 

  51. Göder R, Baier PC, Beith B, et al. Effects of transcranial direct current stimulation during sleep on memory performance in patients with schizophrenia. Schizophr Res. 2013;144:153–4.

    Article  PubMed  Google Scholar 

  52. Pillai V, Kalmbach DA, Ciesla JA. A meta-analysis of electroencephalographic sleep in depression: evidence for genetic biomarkers. Biol Psychiatry. 2011;70:912–9.

    Article  PubMed  Google Scholar 

  53. Tsuno N, Besset A, Ritchie K. Sleep and depression. J Clin Psychiatry. 2005;66:1254–69.

    Article  PubMed  Google Scholar 

  54. Riemann D, Voderholzer U. Primary insomnia: a risk factor to develop depression? J Affect Disord. 2003;76:255–9.

    Article  PubMed  Google Scholar 

  55. •• Baglioni C, Battagliese G, Feige B, et al. Insomnia as a predictor of depression: a meta-analytic evaluation of longitudinal epidemiological studies. J Affect Disord. 2011;135:10–9. This meta-analysis of longitudinal studies revealed that patients with insomnia have a considerably increased risk for the development of depression.

    Article  PubMed  Google Scholar 

  56. Perlis ML, Giles DE, Buysse DJ, et al. Self-reported sleep disturbance as a prodromal symptom in recurrent depression. J Affect Disord. 1997;42:209–12.

    Article  PubMed  CAS  Google Scholar 

  57. Pigeon WR, Hegel M, Unützer J, et al. Is insomnia a perpetuating factor for late-life depression in the IMPACT cohort? Sleep. 2008;31:481–8.

    PubMed  Google Scholar 

  58. McCall WV, Blocker JN, D'Agostino Jr R, et al. Insomnia severity is an indicator of suicidal ideation during a depression clinical trial. Sleep Med. 2010;11:822–7.

    Article  PubMed  Google Scholar 

  59. Bjørngaard JH, Bjerkeset O, Romundstad P, Gunnell D. Sleeping problems and suicide in 75,000 Norwegian adults: a 20 year follow-up of the HUNT I study. Sleep. 2011;34:1155–9.

    PubMed  Google Scholar 

  60. Fawcett J, Scheftner WA, Fogg L, et al. Time-related predictors of suicide in major affective disorder. Am J Psychiatry. 1990;147:1189–94.

    PubMed  CAS  Google Scholar 

  61. •• Watanabe N, Furukawa TA, Shimodera S, et al. Brief behavioral therapy for refractory insomnia in residual depression: an assessor-blind, randomized controlled trial. J Clin Psychiatry. 2011;72:1651–8. This study shows that CBT-I is effective in improving both insomnia and depression in patients with comorbid insomnia and depression.

    Article  PubMed  Google Scholar 

  62. Manber R, Bernert RA, Suh S, et al. CBT for insomnia in patients with high and low depressive symptom severity: adherence and clinical outcomes. J Clin Sleep Med. 2011;7:645–52.

    PubMed  Google Scholar 

  63. Manber R, Edinger JD, Gress JL, et al. Cognitive behavioral therapy for insomnia enhances depression outcome in patients with comorbid major depressive disorder and insomnia. Sleep. 2008;31:489–95.

    PubMed  Google Scholar 

  64. Taylor DJ, Lichstein KL, Winstock J, et al. A pilot study of cognitive-behavioral therapy of insomnia in people with mild depression. Behav Ther. 2007;38:49–57.

    Article  PubMed  Google Scholar 

  65. Peppard PE, Szklo-Coxe M, Hla KM, Yount T. Longitudinal association of sleep-related breathing disorder and depression. Arch Intern Med. 2006;166:1709–15.

    Article  PubMed  Google Scholar 

  66. Harris M, Glozier N, Ratnavadivel R, Grunstein RR. Obstructive sleep apnea and depression. Sleep Med Rev. 2009;13:437–44.

    Article  PubMed  Google Scholar 

  67. Gupta R, Lahan V, Goel D. Prevalence of restless leg syndrome in subjects with depressive disorder. Indian J Psychiatry. 2013;55:70–3.

    Article  PubMed  Google Scholar 

  68. Rottach KG, Schaner BM, Kirch MH, et al. Restless legs syndrome as side effect of second generation antidepressants. J Psychiatry Res. 2008;43:70–5.

    Article  Google Scholar 

  69. Li Y, Mirzaei F, O'Reilly EJ, et al. Prospective study of restless legs syndrome and risk of depression in women. Am J Epidemiol. 2012;176:279–88.

    Article  PubMed  Google Scholar 

  70. Soehner AM, Harvey AG. Prevalence and functional consequences of severe insomnia symptoms in mood and anxiety disorders: results from a nationally representative sample. Sleep. 2012;35:1367–75.

    PubMed  Google Scholar 

  71. van Mill JG, Hoogendijk WJ, Vogelzangs N, et al. Insomnia and sleep duration in a large cohort of patients with major depressive disorder and anxiety disorders. J Clin Psychiatry. 2010;71:239–46.

    Article  PubMed  Google Scholar 

  72. Fernández-Mendoza J, Vela-Bueno A, Vgontzas AN, et al. Nighttime sleep and daytime functioning correlates of the insomnia complaint in young adults. J Adolesc. 2009;32:1059–74.

    Article  PubMed  Google Scholar 

  73. Taylor DJ, Lichstein KL, Durrence HH, et al. Epidemiology of insomnia, depression, and anxiety. Sleep. 2005;28:1457–64.

    PubMed  Google Scholar 

  74. Morphy H, Dunn KM, Lewis M, et al. Epidemiology of insomnia: a longitudinal study in a UK population. Sleep. 2007;30:274–80.

    PubMed  Google Scholar 

  75. Neckelmann D, Mykletun A, Dahl AA. Chronic insomnia as a risk factor for developing anxiety and depression. Sleep. 2007;30:873–80.

    PubMed  Google Scholar 

  76. Ford DE, Kamerow DB. Epidemiologic study of sleep disturbances and psychiatric disorders. An opportunity for prevention? JAMA. 1989;262:1479–84.

    Article  PubMed  CAS  Google Scholar 

  77. LeBlanc M, Mérette C, Savard J, et al. Incidence and risk factors of insomnia in a population-based sample. Sleep. 2009;32:1027–37.

    PubMed  Google Scholar 

  78. Jansson-Fröjmark M, Lindblom K. A bidirectional relationship between anxiety and depression, and insomnia? A prospective study in the general population. J Psychosom Res. 2008;64:443–9.

    Article  PubMed  Google Scholar 

  79. Sánchez-Ortuno MM, Edinger JD. Cognitive-behavioral therapy for the management of insomnia comorbid with mental disorders. Curr Psychiatry Rep. 2012;14:519–28.

    Article  PubMed  Google Scholar 

  80. •• Belleville G, Cousineau H, Levrier K, St-Pierre-Delorme ME. Meta-analytic review of the impact of cognitive-behavior therapy for insomnia on concomitant anxiety. Clin Psychol Rev. 2011;31:638–52. This meta-analysis of 72 studies with 2690 individuals shows that CBT-I has a moderate impact on concomitant anxiety.

    Article  PubMed  Google Scholar 

  81. Sharafkhaneh A, Giray N, Richardson P, et al. Association of psychiatric disorders and sleep apnea in a large cohort. Sleep. 2005;28:1405–11.

    PubMed  Google Scholar 

  82. Asghari A, Mohammadi F, Kamrava SK, et al. Severity of depression and anxiety in obstructive sleep apnea syndrome. Eur Arch Otorhinolaryngol. 2012;269:2549–53.

    Article  PubMed  Google Scholar 

  83. Cho SJ, Hong JP, Hahm BJ, et al. Restless legs syndrome in a community sample of Korean adults: prevalence, impact on quality of life, and association with DSM-IV psychiatric disorders. Sleep. 2009;32:1069–76.

    PubMed  Google Scholar 

  84. Winkelmann J, Prager M, Lieb R, et al. “Anxietas tibiarum”: depression and anxiety disorders in patients with restless legs syndrome. J Neurol. 2005;252:67–71.

    Article  PubMed  CAS  Google Scholar 

  85. Scholz H, Benes H, Happe S, et al. Psychological distress of patients suffering from restless legs syndrome: a cross-sectional study. Health Qual Life Outcomes. 2011;9:73.

    Article  PubMed  Google Scholar 

  86. Edinger JD, Olsen MK, Stechuchak KM, et al. Cognitive behavioral therapy for patients with primary insomnia or insomnia associated predominantly with mixed psychiatric disorders: a randomized clinical trial. Sleep. 2009;32:499–510.

    PubMed  Google Scholar 

Download references

Conflict of Interest

Kai Spiegelhalder declares that he has no conflict of interest.

Wolfram Regen declares that he has no conflict of interest.

Svetoslava Nanovska declares that she has no conflict of interest.

Chiara Baglioni declares that she has no conflict of interest.

Dieter Riemann declares that he has no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Psychiatry and Psychotherapy, University of Freiburg Medical Center, Hauptstraße 5, 79104, Freiburg, Germany

    Kai Spiegelhalder, Wolfram Regen, Svetoslava Nanovska, Chiara Baglioni & Dieter Riemann

  2. Freiburg Institute of Advanced Studies (FRIAS), University of Freiburg, Freiburg, Germany

    Kai Spiegelhalder

Authors
  1. Kai Spiegelhalder
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Wolfram Regen
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Svetoslava Nanovska
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Chiara Baglioni
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Dieter Riemann
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kai Spiegelhalder.

Additional information

This article is part of the Topical Collection on Geriatric Disorders

Rights and permissions

Reprints and permissions

About this article

Cite this article

Spiegelhalder, K., Regen, W., Nanovska, S. et al. Comorbid Sleep Disorders in Neuropsychiatric Disorders Across the Life Cycle. Curr Psychiatry Rep 15, 364 (2013). https://doi.org/10.1007/s11920-013-0364-5

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11920-013-0364-5

Keywords

Search

Navigation