@article{ref1,
title="The role of late life depressive symptoms on the trajectories of insomnia symptoms during antidepressant treatment",
journal="Journal of psychiatric research",
year="2017",
author="Gebara, Marie Anne and Kasckow, John and Smagula, Stephen F. and DiNapoli, Elizabeth A. and Karp, Jordan F. and Lenze, Eric J. and Mulsant, Benoit H. and Reynolds, Charles F.",
volume="96",
number="",
pages="162-166",
abstract="OBJECTIVE: Sleep disturbances are common in late life depression; however, changes in insomnia symptoms during antidepressant treatment need to be characterized further. The objective of this study was two-fold: 1) to describe longitudinal trajectories of insomnia symptoms in older adults receiving antidepressant treatment and 2) to examine whether baseline depressive symptoms were associated with trajectories of sleep over time. <br><br>METHODS: Data was obtained from 680 older adults (aged ≥ 60) with major depression who participated in one of two protocolized open-label antidepressant treatment clinical trials (Maintenance Therapies in Late Life Depression [MTLD-3]; Incomplete Response in Late Life Depression: Getting to Remission [IRL-GRey]). Depression (total score minus sleep items) and sleep (sum of sleep items) outcomes were derived from the Hamilton Depression Rating Scale in the MLTD-3 and Montgomery-Asberg Depression Rating Scale in the IRL-GRey. <br><br>RESULTS: Both datasets identified 5 possible trajectories of insomnia symptoms with about half of the older adults having clinically significant baseline sleep disturbances and minimal improvement following a course of antidepressant treatment (i.e., sub-optimal sleep trajectory). Furthermore, across both datasets, worse baseline depression severity was associated with sub-optimal sleep trajectories. <br><br>CONCLUSION: In older adults receiving antidepressant treatment, those with clinically significant baseline sleep disturbances and greater depression severity may require adjunctive sleep-focused treatment to ameliorate sleep symptoms.<br><br>Copyright © 2017 Elsevier Ltd. All rights reserved.<p /> <p>Language: en</p>",
language="en",
issn="0022-3956",
doi="10.1016/j.jpsychires.2017.10.013",
url="http://dx.doi.org/10.1016/j.jpsychires.2017.10.013"
}