Abstract
BackgroundObservational studies suggest that insomnia might be associated with an increased risk of depression with inconsistent results. This study aimed at conducting a meta-analysis of prospective cohort studies to evaluate the association between insomnia and the risk of depression.MethodsRelevant cohort studies were comprehensively searched from the PubMed, Embase, Web of Science, and China National Knowledge Infrastructure databases (up to October 2014) and from the reference lists of retrieved articles. A random-effects model was used to calculate the pooled risk estimates and 95 % confidence intervals (CIs). The I 2 statistic was used to assess the heterogeneity and potential sources of heterogeneity were assessed with meta-regression. The potential publication bias was explored by using funnel plots, Egger’s test, and Duval and Tweedie trim-and-fill methods.ResultsThirty-four cohort studies involving 172,077 participants were included in this meta-analysis with an average follow-up period of 60.4 months (ranging from 3.5 to 408). Statistical analysis suggested a positive relationship between insomnia and depression, the pooled RR was 2.27 (95 % CI: 1.89–2.71), and a high heterogeneity was observed (I 2 = 92.6 %, P < 0.001). Visual inspection of the funnel plot revealed some asymmetry. The Egger’s test identified evidence of substantial publication bias (P <0.05), but correction for this bias using trim-and-fill method did not alter the combined risk estimates.ConclusionsThis meta-analysis indicates that insomnia is significantly associated with an increased risk of depression, which has implications for the prevention of depression in non-depressed individuals with insomnia symptoms.
Highlights
Observational studies suggest that insomnia might be associated with an increased risk of depression with inconsistent results
In 2011, Baglioni et al [24] performed a meta-analysis to investigate the association between insomnia and the risk of depression, and the results showed that an overall odds ratio (OR) for insomnia to predict depression of 2.60 (95 % confidence interval (CI):1.98–3.42)
The systematic literature search was conducted by two investigators (L.Q.L. and C.M.W.) independently through the PubMed, Embase, Web of Science and China National Knowledge Infrastructure (CNKI) databases for pertinent studies published in English and Chinese from their inception to October 2014
Summary
Observational studies suggest that insomnia might be associated with an increased risk of depression with inconsistent results. This study aimed at conducting a meta-analysis of prospective cohort studies to evaluate the association between insomnia and the risk of depression. Depression is a common mental disorder and is described as a continuum ranging from a few depressive symptoms to major depression [1]. It is one of the leading global burdens of disease (GBD) and is estimated to be one of the top three health concerns by 2020 [2, 3]. Insomnia prevalence has been found to be associated with measurements of worse physical and mental health [14]
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