Potential Maladaptive Sleep-Related Cognitions in Depression with Comorbid Hypersomnolence: An Exploratory Investigation.

Objective/

Background

Dysfunctional sleep-related cognitions (SRCs) have been demonstrated in both insomnia and depression, but have not been evaluated in patients experiencing depression with co-occurring hypersomnolence. Given the prominence of maladaptive thinking in depression with comorbid insomnia, dysfunctional SRCs may also exist in depressed persons experiencing hypersomnolence. Identifying potentially maladaptive SRCs may assist development of cognitive-behavioral strategies to alleviate hypersomnolence and its related impairment, particularly when comorbid with depression.

Participants

Twenty-two unmedicated persons with major depressive disorder (MDD) with comorbid hypersomnolence (MDD+/HYP+), as well as age- and sex-matched persons with MDD without hypersomnolence (MDD+/HYP-) and healthy controls (HC).

Methods

Participants completed the Dysfunctional Beliefs and Attitudes About Sleep-16-item (DBAS-16) and underwent overnight polysomnography. Groups were compared across clinical and sleep domains, as well as DBAS-16 global, subscale, and individual item scores. Additional analyses evaluated DBAS-16 components while controlling for depression severity.

Results

Groups significantly differed across all collected sleep and mood metrics consistent with diagnostic classification. MDD+/HYP+ DBAS-16 global score was significantly elevated, relative to HC, and was comparable to MDD+/HYP-. A DBAS-16 global score significant group effect was maintained while controlling for depression symptom severity, however only individual DBAS-16 items related to quantity and quality of sleep demonstrated particular relevance to MDD+/HYP+ compared to other groups.

Conclusions

Results suggest potentially maladaptive SRCs in MDD+/HYP+. Further efforts are needed to clarify whether these beliefs and attitudes about sleep in persons with hypersomnolence are in fact dysfunctional, as well as identify relevant content for development of a novel hypersomnolence-related SRC metric.