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From Medscape Medical News > Psychiatry

Anxiety, Comorbid Depression Linked to Frequent Insomnia

Barbara Boughton

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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.


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