ABSTRACT
INTRODUCTION Sleep disturbance was identified as one of the main characteristics and biological markers of major depressive disorder (MDD) in adults. Sleep initiation, sleep maintenance and terminal insomnia with unrefreshed sleep and disturbing dreams have been consistently reported in the studies of adults with MDD. Hypersomnia has been reported in a subset of adult depressives. Although sleep disturbances may be present throughout all phases of a depressive disorder, they are most severe during an acute episode. Patients with depression who report sleep disturbances are more likely to attempt suicide than those who do not report difficulties with their sleep. Sleep disorders such as obstructive sleep apnea and periodic limb movement disorder can disrupt sleep to such a degree that patients may have vegetative symptoms of depression. Thus, it is important when assessing a depressed patient with sleep difficulties to consider a thorough sleep assessment to rule out a physiological cause of vegetative symptoms of depression and insomnia. Those with depression who also exhibit sleep disturbance can benefit from behavioral and relaxation training (1).
