A BrainBlogger writer asks: What accounts for the discrepancy between guidelines and clinical practice?
It has long been appreciated that sleep disorders are highly comorbid with psychiatric illness. Ford and Kamerow’s epidemiological study suggests that 40% of respondents with insomnia and 46.5% of respondents with hypersomnia suffer with concurrent mental illness.
Depression is associated with altered sleep architecture, shortened rapid eye movement (REM) sleep latency, increased REM density, and impaired slow wave sleep (SWS). Moreover, the vast majority of antidepressants suppress and in some cases abolish REM sleep. Chronically suppressed REM sleep results in a robust REM rebound upon antidepressant discontinuation.