Insomnia: Insomnia Versus Poor Sleep Quality

Poor sleep quality can occur as a result of sleep apnea or clinical depression. Poor sleep quality is caused by the individual not reaching stage 4 or delta sleep which has restorative properties. There are, however, people who are unable to achieve stage 4 sleep due to brain damage who still lead perfectly normal lives.

Major depressive disorder: Epidemiology

Major depressive disorder affects about 8–17 percent of the population on at least one occasion in their lives, before the age of 40. In some countries, such as Australia, one in four women and one in six men will suffer from depression. In Canada, major depression affects approximately 1.35 million people[citation needed], and in the United States approximately 14 million adults per year.[17] An estimated 121 million people worldwide currently suffer from depression.

Major depressive disorder: Diagnosis

Before a diagnosis of major depressive disorder is made, a physician should perform a medical examination to rule out a physical cause for the suspected depression. Although there are no biological tests which confirm major depression, tests are carried out to exclude medical illnesses; these include blood tests measuring TSH to exclude hypo- or hyperthyroidism, basic electrolytes and serum calcium to rule out a metabolic disturbance, full blood count including ESR to rule out a systemic infection or chronic disease, and serology to exclude syphilis or HIV infection; two commonly ordered investigations are EEG to exclude epilepsy, and a CT scan of the head to exclude brain lesions. Early dementia may present with depressive symptoms in older patients.

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