Objective sleep duration and response to combined pharmacotherapy and cognitive behavioral insomnia therapy among patients with comorbid depression and insomnia: a report from the TRIAD study

Insomnia Comorbid With Depression: A Bibliometric and Visualized Analysis of Research Trends and Hotspots From 2000 to 2024

Background: Sleep disorders, such as insomnia, are pervasive and frequently comorbid with depression, significantly affecting the quality of life of patients. Insomnia is characterized by difficulty initiating or maintaining sleep, which leads to impairment. Depression is characterized by persistent sadness and loss of interest, and it often features symptoms of insomnia. Understanding their interaction will be done for treatment strategies concerning both disorders. Despite the existence of extensive studies on insomnia and depression, there is a significant gap in bibliometric analysis specifically addressing the comorbidity of these two conditions. Objectives: This study is aimed at conducting a bibliometric analysis of research in insomnia comorbid with depression (ICD) to identify research trends, collaboration patterns, influential works, and hotspots. Methods: The study involved performance analysis to evaluate research productivity and trends, science mapping to visualize the intellectual structure and thematic evolution of the field, and network analysis to examine research collaboration and knowledge structure. Tools such as VOSviewer, CiteSpace, and GraphPad Prism were utilized for data analysis. Results: A total of 1624 publications on the comorbidity of insomnia and depression from 2000 to 2024 were included, encompassing both articles and reviews. Publication volume showed a steady growth from 2000 to 2008, followed by a significant increase from 2019 onward. The United States was the most productive country, followed by China. Key authors such as Allison G. Harvey, Charles M. Morin, and Daniel J. Buysse have made substantial contributions to the field. Major influential journals included Sleep Medicine, Journal of Affective Disorders, and Frontiers in Psychiatry. Research trends identified included the exploration of neurobiological mechanisms, cognitive behavioral therapy for insomnia (CBT-i), and personalized treatment approaches. Conclusion: This bibliometric analysis provides valuable insights into the evolving landscape of research on ICD. Future research should focus on personalized, multimodal interventions, expanding the application of CBT-i, exploring neurobiological mechanisms, and improving patients' quality of life through integrated treatment strategies.

Maternal Sleep Health, Social Support, and Distress: A Mixed-Methods Analysis of Mothers of Infants and Young Children in Rural US

OBJECTIVES

The purpose of this study was to explore sleep health in rural maternal populations through a social-ecological framework and identify risk and protective factors for this population.

METHODS

39 individuals who are mothers of infants or children under the age of 5 years completed an online survey, 35 of which completed a subsequent semi-structured interview. Recruitment was limited to one rural community and was in partnership with community healthcare providers. Results were integrated using a convergent, parallel mixed-methods design.

RESULTS

Poor sleep health and high prevalence of insomnia symptoms in rural mothers were evident and associated with social support and maternal distress. Qualitative content from interviews indicated that well-established precipitating and perpetuating factors for insomnia may contribute to poor maternal sleep health. Results also revealed a gap in knowledge and language surrounding sleep health among rural mothers.

CONCLUSIONS

Sleep health is challenged during the transition to motherhood and rural mothers have less access to specialized perinatal and behavioral health care than their urban counterparts. In this sample, poor sleep was attributable to distress in addition to nocturnal infant and child sleep patterns which has implications for psychoeducation and promotion of sleep health in mothers. Sleep is a modifiable health indicator that is associated with several other maternal health outcomes and should be considered an element of a comprehensive maternal health for prevention and intervention across individual, interpersonal, and societal domains of the social-ecological model of sleep health.