Insomnia and depression: neurobiological confluences and treatment

Authors

  • Márcio Andrei Zanini Preceptor da Residência Médica em Psiquiatria, IAMSPE; Hospital do Servidor Público Estadual, São Paulo, SP, Brasil https://orcid.org/0000-0002-1551-7091
  • Camilla Moreira de Sousa Pinna Preceptora da Residência Médica em Psiquiatria do Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro, UFRJ, Rio de Janeiro, RJ, Brasil https://orcid.org/0000-0001-9841-1227
  • Rafael Brandes Lourenço Doutorando em Ciências Médicas, Universidade Estadual de Campinas, UNICAMP, Campinas, SP, Brasil https://orcid.org/0000-0003-0268-5827
  • Flavia Zuccolotto dos Reis Psiquiatra com certificação em Medicina do Sono pela AMB-CFM, São Paulo, SP, Brasil https://orcid.org/0009-0004-5744-2907
  • Daniel Guilherme Suzuki Borges Médico Assistente ASONO – IPq, Hospital das Clínicas, HC, Faculdade de Medicina da Universidade de São Paulo, FMUSP, São Paulo, SP, Brasil https://orcid.org/0009-0008-7886-6687
  • Glícia Prates Santana Psiquiatra com certificação em Medicina do Sono pela AMB-CFM, Vitória da Conquista, BA, Brasil https://orcid.org/0009-0005-7256-0917
  • Regina Margis Psiquiatra com certificação em Medicina do Sono pela AMB-CFM, São Paulo, SP, Brasil
  • Almir Ribeiro Tavares Júnior Professor de Neurociências e Psiquiatria, Universidade Federal de Minas Gerais, UFMG, Belo Horizonte, MG, Brasil https://orcid.org/0000-0001-9517-8546

DOI:

https://doi.org/10.25118/2763-9037.2025.v15.1332

Keywords:

depressive disorder, sleep initiation and maintenance disorders, insomnia, sleep disorder

Abstract

Introduction: The bidirectional relationship between sleep and depression is widely known and described in the literature, as well as observed in clinical practice. Insomnia, in addition to being part of the diagnostic criteria for depression, shows itself as a risk factor for a depressive episode, predicts a lower response to treatment, increased risk of relapses and is associated with a greater severity of the condition in patients with depressive disorder. For adequate treatment, it is essential to understand these entities and the aspects involved in this scenario. Methods: This is a narrative review about the relationship between insomnia and depression, including neurochemical, molecular, chronobiological and epidemiological factors, articulating with currently available therapy. Results: Insomnia and depression share abnormalities in some neurotransmitter systems and brain pathways. Overactivity of the ascending reticular activating system (ARDS) is common to both conditions. Changes in the circadian rhythm and polysomnographic parameters are also found in individuals with depression. Furthermore, epidemiological studies demonstrate that depression is an important predictor of insomnia in a reciprocal way. Conclusions: Based on the various physiological, molecular, genetic and psychological confluences, insomnia and depression influence each other. The use of pharmacological and non-pharmacological tools focusing on the effective management of these two conditions is mandatory to reduce the severity and global chronification of the condition, aiming for legitimate treatment success.

 

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Author Biographies

Márcio Andrei Zanini, Preceptor da Residência Médica em Psiquiatria, IAMSPE; Hospital do Servidor Público Estadual, São Paulo, SP, Brasil

http://lattes.cnpq.br/8069050480622437

Camilla Moreira de Sousa Pinna, Preceptora da Residência Médica em Psiquiatria do Hospital Universitário Clementino Fraga Filho da Universidade Federal do Rio de Janeiro, UFRJ, Rio de Janeiro, RJ, Brasil

http://lattes.cnpq.br/3191029579908434

Rafael Brandes Lourenço, Doutorando em Ciências Médicas, Universidade Estadual de Campinas, UNICAMP, Campinas, SP, Brasil

http://lattes.cnpq.br/6654584691382531

Flavia Zuccolotto dos Reis, Psiquiatra com certificação em Medicina do Sono pela AMB-CFM, São Paulo, SP, Brasil

http://lattes.cnpq.br/3710777352705280

Daniel Guilherme Suzuki Borges, Médico Assistente ASONO – IPq, Hospital das Clínicas, HC, Faculdade de Medicina da Universidade de São Paulo, FMUSP, São Paulo, SP, Brasil

http://lattes.cnpq.br/9430695171810857

Glícia Prates Santana, Psiquiatra com certificação em Medicina do Sono pela AMB-CFM, Vitória da Conquista, BA, Brasil

http://lattes.cnpq.br/6193825830756887

Regina Margis, Psiquiatra com certificação em Medicina do Sono pela AMB-CFM, São Paulo, SP, Brasil

http://lattes.cnpq.br/4126517391759813

https://orcid.org/0009-0004-3133-2507

 

Almir Ribeiro Tavares Júnior, Professor de Neurociências e Psiquiatria, Universidade Federal de Minas Gerais, UFMG, Belo Horizonte, MG, Brasil

https://lattes.cnpq.br/5215895509002939

 

 

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2025-01-17

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Zanini MA, Pinna CM de S, Lourenço RB, Reis FZ dos, Borges DGS, Santana GP, et al. Insomnia and depression: neurobiological confluences and treatment. Debates em Psiquiatria [Internet]. 2025 Jan. 17 [cited 2025 Mar. 12];15:1-28. Available from: https://revistardp.org.br/revista/article/view/1332

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