Psychiatric disorders and sleep disturbances
Psychiatric Disorders and Sleep Disturbances Sleep complaints such as insomnia and hypersomnia are common. Physicians must determine whether such complaints represent a primary sleep disorder or a manifestation of a somatic disorder, such as obstructive sleep apnea, or a psychiatric illness, such as depression. To determine the prevalence of sleep disturbances and their relationship to sociodemographic variables, mental disorders and the use of health and mental health services, Ford and Kamerow analyzed data from the National Institute of Mental Health Epidemiologic Catchment Area survey of 7,954 community residents.
Survey respondents were questioned at baseline and one year later about their sleep complaints and psychiatric symptoms. Only individuals with relatively severe complaints were classified as having a sleep disturbance. A standarlized interview was used to make psychiatric diagnoses. Of this community sample, 10.2 percent reported significant insomnia and 3.2 percent reported significant hypersomnia at the first interview. A psychiatric diagnosis was identified in 40.4 percent of the participants with insomnia and in 46.5 percent of those with hypersomnia, compared with 16.4 percent of those which no sleep complaints. The risk of developing a new episode of major depression was much higher in those respondents who reported insomnia at both the baseline and second interviews than in those whose sleep complaints had resolved.
The authors conclude that sleep complaints are common in general medical settings and are strongly related to psychiatric disorders. They suggest that primary care physicians inquire about sleep problems. The possibility of a mental disorder should be investigated in those patients who report sleep problems. Propective research is needed to determine if early recognition and treatment of sleep disturbances can prevent future psychiatric disorders. (JAMA, September 15, 1989, vol. 262, p. 1479.)
COPYRIGHT 1990 American Academy of Family Physicians
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