A pilot study of antidepressant therapy on sleep architecture in patients with depression in Congo

Background: A pilot prospective cohort study was conducted to study the sleep architecture and correlated perceived sleep disturbances in depressed Congolese patients with objective changes in sleep architecture using polysomnography (PSG) before and after antidepressant therapy. Methods: Patients were recruited into the study after applying strict inclusion and exclusion criterion to rule out other comorbidities which could influence sleep. A diagnosis of depressive episode was made based on the International Classification of Diseases-10 Edition DCR. Patients were evaluated using Beck Depressive inventory (BDI) and (Hamilton Depression Rating Scale (HAM-D) insomnia subscale on day 1 of admission. Patients also received sleep study using polysomnography on day 3 of the hospitalization. Patients were started on antidepressant treatment after polysomnography. Patients received an eight-week adequate trial of antidepressants, and BDI score being lower than 9 was considered as being remitted from depression. Polysomnography was repeated after that the patients achieved remission. Statistical analysis was done using Kruskal–Wallis test and Pearson's correlation coefficient. Results: The study results showed that significantly improved polysomnographic findings existed in total sleep time (p < 0.001), sleep efficiency (p < 0.001), wake after sleep onset (p < 0.001), and percentage wake time (p < 0.001) after taking antidepressants. HAM-D insomnia subscale was correlated with total sleep time (p < 0.001), sleep efficiency (p < 0.001), wake after sleep onset (p < 0.001), total wake time (p < 0.001), and N2 stage percentage (p < 0.001). Conclusion: Antidepressant treatment effectively improved sleep architecture in depressive disorder. HAM-D insomnia subscale was correlated with objective findings of total sleep time, sleep efficiency, wake after sleep onset, as well as total wake time and duration of N2 stage of nonrapid eye movement (NREM).