The search was restricted to studies in humans. The key words used as the search terms were the following: “insomnia”, “sleep disorder”, “sleep disturbance”, “sleep problem”, “sleep quality”,”sleep duration” in combination with “depression”, “mental disorder”, and “anxiety”. and C.M.W.) independently through the PubMed, Embase, Web of Science and China National Knowledge Infrastructure (CNKI) databases for pertinent studies published in English and Chinese from their inception to October 2014. The systematic literature search was conducted by two investigators (L.Q.L. This meta-analysis was performed according to the checklist of the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) guidelines. Therefore, we conducted an updated-analysis to further investigate the issue. Including more studies and enlarging the sample size would be important for strengthening the reliability of describing the association between insomnia and depression risk. ![]() The incidences and the risk factors for depression might vary with the definitions of depression and the exposure changes, or vary in samples from different gender, follow-up durations, and geographic regions. In addition, the previous review only conducted a subgroup analysis by different age groups of participants. Since then, many new observational studies have emerged, and some of them had large sample sizes and long follow-up lengths. performed a meta-analysis to investigate the association between insomnia and the risk of depression, and the results showed that an overall odds ratio (OR) for insomnia to predict depression of 2.60 (95 % confidence interval (CI):1.98–3.42). Many observational studies have focused on whether insomnia has an influence on depression risk. The identification of modifiable risk factors for depression has a greatly important implication for the primary prevention. It has been reported that insomnia is associated with an increased risk of depression and/or anxiety disorders. īoth insomnia and depression are major public health problems. Insomnia prevalence has been found to be associated with measurements of worse physical and mental health. Epidemiological studies have shown that 20 to 35 % of the general population report insomnia symptoms, and that 10 to 20 % have clinically significant insomnia syndrome. Insomnia is the subjective feeling of having difficulties initiating or maintaining sleep (DIS and DMS respectively, jointly referred to as DIMS) or of non-restorative sleep (NRS). ![]() Among older adults in Japan, depression is one of the most common diseases and is a leading cause of morbidity and mortality. Some evidence showed that 5.8 % of men and 9.5 % of women would experience a depressive episode in any given year for a lifetime. It is one of the leading global burdens of disease (GBD) and is estimated to be one of the top three health concerns by 2020. This meta-analysis indicates that insomnia is significantly associated with an increased risk of depression, which has implications for the prevention of depression in non-depressed individuals with insomnia symptoms.ĭepression is a common mental disorder and is described as a continuum ranging from a few depressive symptoms to major depression. The Egger’s test identified evidence of substantial publication bias ( P <0.05), but correction for this bias using trim-and-fill method did not alter the combined risk estimates. Visual inspection of the funnel plot revealed some asymmetry. Statistical analysis suggested a positive relationship between insomnia and depression, the pooled RR was 2.27 (95 % CI: 1.89–2.71), and a high heterogeneity was observed ( I 2 = 92.6 %, P < 0.001). ![]() Thirty-four cohort studies involving 172,077 participants were included in this meta-analysis with an average follow-up period of 60.4 months (ranging from 3.5 to 408). The potential publication bias was explored by using funnel plots, Egger’s test, and Duval and Tweedie trim-and-fill methods. The I 2 statistic was used to assess the heterogeneity and potential sources of heterogeneity were assessed with meta-regression. A random-effects model was used to calculate the pooled risk estimates and 95 % confidence intervals (CIs). Relevant cohort studies were comprehensively searched from the PubMed, Embase, Web of Science, and China National Knowledge Infrastructure databases (up to October 2014) and from the reference lists of retrieved articles. This study aimed at conducting a meta-analysis of prospective cohort studies to evaluate the association between insomnia and the risk of depression. ![]() Observational studies suggest that insomnia might be associated with an increased risk of depression with inconsistent results.
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