Gao Tao, Xiang Han, Wu Qian Nan, Zhu Li Shan, Pei Wan Juan, Fu Wei Jie, Chou Tian Shu
Hunan University of Chinese Medicine, Changsha, Hunan, China.
Front Psychiatry. 2025 Mar 26;16:1468212. doi: 10.3389/fpsyt.2025.1468212. eCollection 2025.
Insomnia and depression, both significantly impacting public health, are common psychosomatic illnesses that frequently co-occur in the same individual. Not only do these two conditions commonly co-occur, but they also exhibit a bidirectional link, where the existence of one may heighten the risk for the other. Latest research offers compelling evidence of significant overlap in biological, psychological, and sociological aspects in the comorbidity of insomnia and depression. Building on this, we aim to examine the pathophysiology of insomnia and depression, along with their comorbid mechanisms, encompassing biological routes (like genetics, HPA axis, immune-inflammatory activation, neuroendocrine regulation, microbiome alterations, and neural circuits integrating sleep and emotion regulation), as well as psychosocial routes. Consequently, proposing a self-perpetuating and mutually reinforcing "snowball effect" model of comorbid insomnia and depression, and examining corresponding preventative intervention strategies to rectify associated imbalances. Finally, this article encapsulates the challenges in this field of study and the directions for future research. Finally, the paper points out the limitations of current research (cross-sectional data being dominant, and the mechanism of multi-omics dynamics being unknown) and the future direction (longitudinal cohort combined with computational modeling to resolve temporal interactions), which will provide a theoretical basis for precision interventions.
失眠和抑郁症都是对公众健康有重大影响的常见身心疾病，经常在同一个体中同时出现。这两种情况不仅经常同时发生，而且还呈现出双向联系，即一种情况的存在可能会增加另一种情况的风险。最新研究提供了令人信服的证据，表明失眠和抑郁症共病在生物学、心理学和社会学方面存在显著重叠。在此基础上，我们旨在研究失眠和抑郁症的病理生理学及其共病机制，包括生物学途径（如遗传学、HPA轴、免疫炎症激活、神经内分泌调节、微生物群改变以及整合睡眠和情绪调节的神经回路）以及心理社会途径。因此，提出一种失眠和抑郁症共病的自我延续和相互强化的“雪球效应”模型，并研究相应的预防性干预策略，以纠正相关的失衡。最后，本文总结了该研究领域的挑战和未来研究方向。最后，论文指出了当前研究的局限性（横断面数据占主导，多组学动态机制未知）和未来方向（纵向队列结合计算建模以解决时间相互作用），这将为精准干预提供理论基础。
