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Subject Nursing Pages 5 Style APA


Sleep Disturbance

Sleep disturbance is prevalent among majority of individuals (Gillin, 1998). Individuals suffering from sleeping disorder experience various symptoms ranging from abnormal short or long sleep durations to poor sleep quality and difficulties in catching sleep. In health and clinical sphere, sleep quality is critical with between 15-35% of adult population suffering from poor quality slaap. According to Buysse, Reynolds, Monk, Berman & Kupfer (1989), poor sleep quality is indicative of other disorders such as sleep, psychological and physical disorders that an individual may be having. This means that inadequate sleep impacts on the mental and physical health of individuals manifesting through symptoms such as loss of attentiveness, low threshold for pain, irrational thoughts, hallucination, anxiety and loss of appetitive (Augner, 2011). Atalay (2011) notes that barely in all psychiatric disorders, victims experience anxiety, depression and sleep quality disturbances.  World Health Organization (WHO) acknowledges that depression is one of the common disorders usually characterized by loss of interest in normal activities an individual enjoys, persistent sadness that often affects an individual capability to engage in the daily activities for estimated two weeks (Atalay, 2011).

The Diagnostic and Statistical Manual of Mental Disorders (DSM5), one of the tools used by psychiatrics for diagnoses defines anxiety disorders as disorders that have similar features of anxiety and excessive fear and related behavior disturbances. Anxiety arises when a person anticipates future threats, whereas fear is an emotional response to perceived imminent or real threat (Augner, 2011).

According to Mayers, Grabau, Campbell & Baldwin (2009), there is a relationship between depression and sleep disturbances. In one of the longitudinal studies, it was established that individuals a history of insomnia are susceptible to developing depression as opposed to those without such precious cases (Breslau, Roth, Rosenthal & Andreski, 1996). Because of close connection between depression and insomnia, this has attracted interest from researchers, explaining the many epidemiological studies already conducted in the area. In a survey study conducted for 34 years on 1053 graduates by Chang et al. (1997), findings revealed that there were high chances of students with insomnia developing depression later in their life. Similarly, other studies revealed worsening of insomnia syndrome, especially among patients that experience recurrent major depressive disorder when approaching new episodes of depression. This therefore, suggests that sleep disturbance may trigger precipitate new episodes or may be a prodromal symptom of relapse (Papadimitriou & Linkowski, 2005). Worth noting is that persistent insomnia can be a risk factor in the late life depression as sleep disturbance can also result to poor mental health in future. Evidence exists where depression is represented in sleep disorder individuals and sleep disturbances manifesting among individuals with depression. According to Buysse et al. (2008), 90% of patients suffering from depression experience poor quality sleep. In other retrospective study done on teenage aged between 13-16 years, findings revealed that proceeding insomnia was associated with onset of depression, whereas onset of insomnia was not associated with preceding depression.

Insomnia and anxiety disorders prevalent are high with high damaging effect and capability to occur concurrently. Sleep disturbances have been proven to increase anxiety which in turn affects the quality of sleep (Papadimitriou & Linkowski, 2005). In addition, initiating sleep can be a challenge with heightened physiological aroused closely linked with anxiety sensitivity. Hayashino et al. (2010) shows existence of correlation between sleep disturbances with comorbid psychological disorders such as anxiety and depression. Similarly, LeBlanc et al. (2007) noted association between insomnia, higher depression and anxiety and low quality of life. Overall, many studies have established a connection between sleep disturbances, anxiety and depression. Others have suggested cause and effect association (Batterham, Glozier & Christensen, 2012).

Indeed sleep quality remains a burden on the mental wellbeing of individuals; however, it is unclear whether multiple comorbid and depression have additional consequences on sleep quality. Due to close link between sleep problems and mental disorders, early intervention of depression and anxiety is possible with proper management of sleep disturbance.






Augner, C. (2011). Associations of subjective sleep quality with depression score, anxiety,            physical symptoms and sleep onset latency in students. Cent Eur J Public Health,          19(2):115-7.

Atalay, H. (2011). Comorbidity of insomnia detected by the Pittsburgh sleep quality index            with anxiety, depression and personality disorders. Isr J Psychiatry Related          Science, 48(1):54-9.

Batterham, P., Glozier, N., & Christensen, H. (2012).  Sleep disturbance, personality and the        onset of depression and anxiety: prospective cohort study. Aust N Z J Psychiatry,     46(11):1089-98.

Buysse, D., Reynolds, C., Monk, T., Berman, S., & Kupfer, D. (1989). The Pittsburgh sleep             quality index: A new instrument for psychiatric practice and research. Psychiatry    Research, 28(2):193-213

Buysse, D., Angst, J., Gamma, A., Ajdacic, V., Eich, D., &WulfRössler, M. (2008).    Prevalence, Course, and Comorbidity of Insomnia and Depression in Young Adults.   Sleep, 31(4): 473–480.

Breslau, N., Roth, T., Rosenthal, L., & Andreski, P. (1996).  Sleep disturbance and               psychiatric disorders: A longitudinal epidemiological study of young Adults. Biological Psychiatry, 39(6):411-418.

Gillin, J. (1998). Are sleep disturbances risk factors for anxiety, depressive and addictive disorders? ActaPsychiatriciaScandinavica, 98(393): 39-43.

Hayashino, Y., Yamazaki, S., Takegami, M., Takeo, N., Sokejima, S., Fukuhara, S., (2010). Association between number of comorbid conditions, depression, and sleep quality        using the Pittsburgh Sleep Quality Index: Results from a population-based survey.        Sleep medicine, 11. DO  – 10.1016/j.sleep.2009.05.021

Leblanc, E., Narducci, F., Frumovitz, M., Lesoin, A., Castelain, B., Baranzelli, M., Taieb, S.,               Fournier, C., &Querleu, D. (2007).  Therapeutic value of pretherapeutic       extraperitoneal laparoscopic staging of locally advanced cervical carcinoma. Gynecol                Oncol, 105(2):304-11.

Mayers, A., Grabau, E., Campbell, C., & Baldwin, D. (2009). Subjective sleep, depression and anxiety: inter-relationships in a non-clinical sample. Hum Psychopharmacol,        24(6):495-501.

Papadimitriou, G., & Linkowski, P. (2005). Sleep disturbance in anxiety disorders. Int Rev               Psychiatry, 17(4):229-36.



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