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

Autor:	Mak MSB; Department of Psychiatry (MSBM, DMB, AJF, BHM), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Centre for Addiction and Mental Health (MSBM, DMB, BHM), Toronto, Canada., Gebara MA; Department of Psychiatry (MAG, CFR, STS), University of Pittsburgh School of Medicine, Toronto, Canada., Lenze EJ; Department of Psychiatry (EJL, PC), Washington University School of Medicine in St. Louis, St. Louis, MO., Blumberger DM; Department of Psychiatry (MSBM, DMB, AJF, BHM), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Centre for Addiction and Mental Health (MSBM, DMB, BHM), Toronto, Canada., Brown PJ; Department of Psychiatry (PJB, SPR), Columbia University College of Physicians and Surgeons and the New York State Psychiatric Institute, New York, NY., Cristancho P; Department of Psychiatry (EJL, PC), Washington University School of Medicine in St. Louis, St. Louis, MO., Flint AJ; Department of Psychiatry (MSBM, DMB, AJF, BHM), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Centre for Mental Health (AJF), University Health Network, Toronto, Canada., Karp JF; Department of Psychiatry (JFK), College of Medicine, University of Arizona, Tucson, AZ., Lavretsky H; Department of Psychiatry and Biobehavioral Sciences (HL), University of California, Los Angeles., Miller JP; Data Science and Biostatistics (JPM), Washington University School of Medicine in St. Louis, Institute for Informatics, St. Louis, MO., Reynolds CF 3rd; Department of Psychiatry (MAG, CFR, STS), University of Pittsburgh School of Medicine, Toronto, Canada., Roose SP; Department of Psychiatry (PJB, SPR), Columbia University College of Physicians and Surgeons and the New York State Psychiatric Institute, New York, NY., Mulsant BH; Department of Psychiatry (MSBM, DMB, AJF, BHM), Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Centre for Addiction and Mental Health (MSBM, DMB, BHM), Toronto, Canada. Electronic address: benoit.mulsant@utoronto.ca., Stahl ST; Department of Psychiatry (MAG, CFR, STS), University of Pittsburgh School of Medicine, Toronto, Canada.
Jazyk:	angličtina
Zdroj:	The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry [Am J Geriatr Psychiatry] 2024 Aug 13. Date of Electronic Publication: 2024 Aug 13.
DOI:	10.1016/j.jagp.2024.07.020
Abstrakt:	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. (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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