Poor Sleep is Common in Treatment-Resistant Late-life Depression and Associated With Poorer Antidepressant Response: Findings From the OPTIMUM Clinical Trial.

IF 4.4 2区医学 Q1 GERIATRICS & GERONTOLOGY

American Journal of Geriatric Psychiatry Pub Date : 2024-08-13 DOI:10.1016/j.jagp.2024.07.020

Michael S B Mak, Marie Anne Gebara, Eric J Lenze, Daniel M Blumberger, Patrick J Brown, Pilar Cristancho, Alastair J Flint, Jordan F Karp, Helen Lavretsky, J Philip Miller, Charles F Reynolds, Steven P Roose, Benoit H Mulsant, Sarah T Stahl

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引用次数: 0

Abstract

Background: Adults with treatment-resistant late-life depression (TRLLD) have high rates of sleep problems; however, little is known about the occurrence and change in sleep during pharmacotherapy of TRLLD. This analysis examined: (1) the occurrence of insufficient sleep among adults with TRLLD; (2) how sleep changed during pharmacotherapy; and (3) whether treatment outcomes differed among participants with persistent insufficient sleep, worsened sleep, improved sleep, or persistent sufficient sleep.

Methods: Secondary analysis of data from 634 participants age 60+ years in the OPTIMUM clinical trial for TRLLD. Sleep was assessed using the sleep item from the Montgomery-Asberg Depression Rating Scale at the beginning (week-0) and end (week-10) of treatment. The analyses examined whether treatment outcomes differed among participants with persistent insufficient sleep, worsened sleep, improved sleep, or persistent sufficient sleep during depression treatment.

Results: About half (51%, n = 323) of participants reported insufficient sleep at baseline. Both persistent insufficient sleep (25%, n = 158) and worsened sleep (10%, n = 62) during treatment were associated with antidepressant nonresponse. Participants who maintained sufficient sleep (26%, n = 164) or who improved their sleep (n = 25%, n = 158) were three times more likely to experience a depression response than those with persistent insufficient sleep or worsened sleep.

Conclusion: Insufficient sleep is common in TRLLD and it is associated with poorer treatment response to antidepressants.

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晚期抑郁症患者普遍存在睡眠质量差的问题，这与抗抑郁药反应较差有关：OPTIMUM临床试验的结果。

背景：成人晚期抗药性抑郁症（TRLLD）患者的睡眠问题发生率很高；然而，人们对TRLLD药物治疗期间睡眠问题的发生和变化知之甚少。本分析研究了：（1）TRLLD 成年人睡眠不足的发生情况；（2）药物治疗期间睡眠的变化情况；以及（3）持续睡眠不足、睡眠恶化、睡眠改善或持续睡眠充足的参与者之间的治疗结果是否存在差异：对OPTIMUM治疗TRLLD临床试验中634名60岁以上参与者的数据进行二次分析。在治疗开始（第0周）和结束（第10周）时，使用蒙哥马利-阿斯伯格抑郁评分量表中的睡眠项目对睡眠进行评估。分析研究了抑郁症治疗期间睡眠持续不足、睡眠恶化、睡眠改善或睡眠持续充足的参与者的治疗结果是否存在差异：约半数参与者（51%，n = 323）在基线时报告睡眠不足。治疗期间持续睡眠不足（25%，n = 158）和睡眠恶化（10%，n = 62）都与抗抑郁药无反应有关。保持充足睡眠（26%，n = 164）或睡眠改善（n = 25%，n = 158）的参与者出现抑郁反应的几率是持续睡眠不足或睡眠恶化者的三倍：结论：睡眠不足在TRLLD中很常见，而且与抗抑郁药物治疗反应较差有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Geriatric Psychiatry 医学-精神病学

CiteScore

13.00

自引率

4.20%

发文量

381

审稿时长

26 days

期刊介绍： The American Journal of Geriatric Psychiatry is the leading source of information in the rapidly evolving field of geriatric psychiatry. This esteemed journal features peer-reviewed articles covering topics such as the diagnosis and classification of psychiatric disorders in older adults, epidemiological and biological correlates of mental health in the elderly, and psychopharmacology and other somatic treatments. Published twelve times a year, the journal serves as an authoritative resource for professionals in the field.