Kristiansen Sanne T, Lyhne Cecilie N, Kragh Mette, Sigaard Karen R, Videbech Poul, Larsen Erik R, Bjerrum Merete B
Research Unit for Nursing and Health Care, Department of Public Health, Health, Aarhus University, Aarhus, Denmark.
Department of Affective Disorders, Aarhus University Hospital, Aarhus N, Denmark.
JBI Evid Synth. 2024 Dec 1;22(12):2447-2517. doi: 10.11124/JBIES-23-00499.
The objective of this review was to identify and synthesize the best available evidence on how adult patients experience living with depression-related insomnia, and their experiences related to pharmacological and non-pharmacological interventions aimed at improving sleep.
Insomnia affects 80% to 90% of patients with depression. The costs of insomnia are considerable for the individual and society alike. To understand the role and consequences of insomnia for an individual with depression and to optimize sleep interventions, an in-depth understanding of patients' experiences is needed. Therefore, this review addresses how adult patients experience living with depression-related insomnia, along with their experiences of pharmacological and non-pharmacological sleep interventions.
Studies focusing on adult patients aged 18 years and older with a diagnosis of depression who had experiences with insomnia and pharmacological and/or non-pharmacological sleep interventions were included. All studies with qualitative research findings from inpatient and outpatient populations were considered.
The following databases were searched: MEDLINE (PubMed), Embase, CINAHL (EBSCOhost), PsycINFO (ProQuest), Cochrane CENTRAL, SveMed+, Scopus, and Web of Science Core Collection. Google Scholar and ProQuest Dissertations and Theses were searched for eligible dissertations and theses. The searches were conducted on May 3-5, 2022, and updated on June 13-19, 2023. Studies published in English, Danish, German, Norwegian, and Swedish were considered. Databases were searched from their inception to the search date. All studies were screened against the inclusion criteria, and critically and independently appraised by 2 reviewers for methodological quality. Findings were pooled using meta-aggregation, and a ConQual Summary of Findings was created.
Ten qualitative studies were included. The studies were conducted in 6 countries and counted a total of 176 participants. In all, 127 findings were extracted and aggregated into 11 categories. From the 11 categories, 3 synthesized findings were developed: i) Disruption of sleep challenges coping with everyday life by depleting both physical and mental resources; ii) Sleep is an escape and a protective factor against suicide; and iii) Choices, support, and personalized interventions from non-pharmacological approaches addressing depression-related insomnia are valued.
This review underlined the relationship between depression-related insomnia, its profound impact on individuals' lives, and the value of non-pharmacological sleep interventions to address these issues. Specifically, the review revealed the physical and emotional consequences of insomnia while emphasizing how wakefulness during night hours may exacerbate feelings of loneliness and vulnerability to negative thoughts and suicide. Moreover, it provides an overview of patients' experiences of non-pharmacological approaches to address depression-related insomnia and highlights their diverse treatment experiences and preferences.
A Danish-language version of the abstract of this review is available as supplemental digital content: http://links.lww.com/SRX/A64 .
PROSPERO CRD42021276048.
本综述的目的是识别和综合现有最佳证据，以了解成年抑郁症患者如何经历与抑郁症相关的失眠，以及他们在旨在改善睡眠的药物和非药物干预方面的经历。
失眠影响80%至90%的抑郁症患者。失眠对个人和社会的成本都相当可观。为了了解失眠对抑郁症患者的作用和后果，并优化睡眠干预措施，需要深入了解患者的经历。因此，本综述探讨成年患者如何经历与抑郁症相关的失眠，以及他们在药物和非药物睡眠干预方面的经历。
纳入的研究聚焦于年龄在18岁及以上、被诊断为抑郁症且有失眠经历以及药物和/或非药物睡眠干预经历的成年患者。所有具有来自住院和门诊人群的定性研究结果的研究均被纳入考虑。
检索了以下数据库：MEDLINE（PubMed）、Embase、CINAHL（EBSCOhost）、PsycINFO（ProQuest）、Cochrane CENTRAL、SveMed+、Scopus和Web of Science核心合集。在谷歌学术和ProQuest学位论文与学术论文数据库中搜索符合条件的学位论文。检索于2022年5月3日至5日进行，并于2023年6月13日至19日更新。考虑发表于英语、丹麦语、德语、挪威语和瑞典语的研究。数据库从创建到检索日期进行搜索。所有研究均根据纳入标准进行筛选，并由2名评审员对方法学质量进行严格且独立的评估。研究结果通过元聚合进行汇总，并创建了一份ConQual研究结果总结。
纳入了10项定性研究。这些研究在6个国家开展，共有176名参与者。总共提取了127项研究结果并汇总为11个类别。从这11个类别中得出了3个综合研究结果：i）睡眠中断通过耗尽身心资源来挑战日常生活应对能力；ii）睡眠是一种逃避方式以及预防自杀的保护因素；iii）来自解决与抑郁症相关失眠的非药物方法的选择、支持和个性化干预受到重视。
本综述强调了与抑郁症相关的失眠之间的关系、其对个人生活的深远影响以及非药物睡眠干预在解决这些问题方面的价值。具体而言，该综述揭示了失眠的身体和情感后果，同时强调夜间清醒如何可能加剧孤独感以及产生消极想法和自杀的易感性。此外，它概述了患者在采用非药物方法解决与抑郁症相关失眠方面的经历，并突出了他们多样的治疗经历和偏好。
本综述的丹麦语摘要版本可作为补充数字内容获取：http://links.lww.com/SRX/A64 。
PROSPERO CRD42021276048 。
