Quality of sleep and its associated factors in patients with major depressive disorder at Out Patients Department, Somdet Chaopraya Institute of Psychiatry

Abstract

Background: Poor sleep quality is a common symptom among patients with major depressive disorder, which increases treatment duration, disease severity and relapse rate. However, there are limited studies on sleep quality among these patients in Thailand.

Objectives: To explore the sleep quality and its associated factors in patients with major depressive disorder (MDD) at Out Patients Department, Somdet Chaopraya Institute of Psychiatry.

Methods: This is a cross-sectional and descriptive study utilizing the information from 187 MDD out patients at the institute. The data were collected by a series of questionnaires to elicit general demography. The Pittsburgh Sleep Quality Index (PSQI), dysfunction belief and attitude about sleep (DBAS-16). Sleep Hygiene behavior questionnaire and the Beck Depression Inventory II (BDI-II). The results were analyzed by descriptive statistics, Chi - square test and multivariate multiple logistic regression.

Results: In all, 72.2 % of the respondents were women with the mean age of 44.1 14.9 years. The prevalence of poor-quality sleep was 74.3%, 37.4% responded to symptoms of severe depression. They also exhibited high erroneous understanding about sleep (66.8%), and only 39.6% followed proper sleep hygiene. Factors found associated with sleep quality were, namely: age, marital status, alcohol use, tobacco-use, caffeine usage, exercise, environment, level of income, the severity of depressive symptoms, concurrent medications, sleep hygiene practice and attitude and beliefs about sleep. Factors that could determine the quality of sleep were
moderate to severe depressive symptoms, level of brightness, high-level of inaccurate attitude and belief about sleep, alcohol usage and low income.

Conclusion: Most of the respondents reported inadequate quality of sleep, high-level of inaccurate attitude and belief about sleep, and low sleep hygiene. The associated and predictive factors of poor sleep quality were moderate to severe depressive symptoms, highlevel of inaccurate attitude and belief about sleep, level of brightness, alcohol use and low income. A better understanding of these factors, especially attitude and belief about sleep and sleep hygiene, could help improve the quality of sleep in similar patients.