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Sleep Med Rev. 2010 Feb;14(1):35-46. doi: 10.1016/j.smrv.2009.09.003. Epub 2009 Nov 25.

Comorbidity of insomnia and depression.

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  • 1Sleep Laboratory, Forenap, Centre Hospitalier de Rouffach, 27 rue du 4√®me R.S.M. F-68250 Rouffach, France.


During the last decade, several studies have shown that insomnia, rather than a symptom of depression, could be a medical condition on its own, showing high comorbidity with depression. Epidemiological research indicates that insomnia could lead to depression and/or that common causalities underlie the two disorders. Neurobiological and sleep EEG studies suggest that a heightened level of arousal may play a common role in both conditions and that signs of REM sleep disinhibition may appear in individuals prone to depression. The effects of antidepressant drugs on non-REM and REM sleep are discussed in relation to their use in insomnia comorbid with depression. Empirical treatment approaches are behavioral management of sleep combined with prescription of a sedative antidepressant alone, co-prescription of two antidepressants, or of an antidepressant with a hypnotic drug.

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