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date: 19 November 2019

Abstract and Keywords

Major depressive disorder (MDD) commonly occurs with several sleep disorders, including hypersomnia, breathing or limb-related sleep disturbances, and most notably chronic insomnia. A bidirectional relationship exists between sleep and mood problems, and both issues often warrant timely clinical management. However, there are several assessment- and treatment-related complexities that complicate the clinical management of such patients. For example, there are several overlapping symptoms for MDD and both insomnia and hypersomnia, and the two sleep conditions are both listed as possible symptoms in the diagnostic criteria for MDD. This has led to a well-documented problem of underrecognizing and undertreating these significant disorders in the context of MDD. Moreover, certain effective depression treatments can actually worsen the coexisting sleep disorder. Understanding and treating both disorders (i.e., MDD and the co-occurring sleep disorder) is imperative for effective clinical care. Almost all (i.e., up to 90%) of those with depression report sleep problems. This chapter provides an overview of the etiologic, assessment, and treatment issues inherent in this very large, highly prevalent group.

Keywords: insomnia, hypersomnia, sleep disorders, major depressive disorder, treatment issues

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