Sleep-related worry, sleep hygiene and associated factors in patients with depressive disorders at Psychiatric Outpatient Department, King Chulalongkorn Memorial Hospital

Abstract

Background: Previous studies have shown that patients with depressive disorders suffered greatly from symptoms of insomnia and struggled to comply with sleep hygiene practice, causing strong dissatisfaction over sleep quantity and its quality. However, studies on sleep-related worry, sleep hygiene and its associated factors in Thai depressed patient are still limited.
Objective: To study sleep-related worry and sleep hygiene behaviors among depressed patients at department of psychiatry, King Chulalongkorn Memorial Hospital (KCMH), and to determine any associated factors on depression and sleep behaviors with sleep-related worry.
Methods: This was a cross-sectional study conducted at the department of psychiatry, KCMH. We recruited 144 patients aged 18 years and above diagnosed with major depressive disorder, persistent depressive disorder or unspecified depressive disorder using diagnostic and statistical manual of mental disorders, fifth edition (DSM-5) criteria. All subjects completed demographic questionnaires, the anxiety and preoccupation about sleep questionnaire (APSQ), the sleep hygiene awareness and practice scale (SHAPS) and the quick inventory of depressive symptomatology (QIDS SR-16). Subsequently, medical records were accessed obtaining data on type of depressive disorder, duration of depression treatment at KCMH and current antidepressants.
Results: Most subjects were female. The median standard deviation of sleep-related worry was 56.95 (26.99) scores (interquartile range) of sleep-related worry on APSQ, sleep hygiene practice on SHAPS were 61.0 (35.5 - 77.8) and 32.0 (24.0 - 45.0) respectively. Factors related with sleep-related worry were sleep hygiene practice, sleep onset latency, sleep disturbances, excessive daytime sleepiness, sleep efficiency, depressive symptoms, and total sleep time (P < 0.001).
Conclusion: These findings can be applied in reducing sleep-related worry among the depressed patients by promoting good sleep quality through an individual or group sleep hygiene psychoeducation.