Major Depressive Disorder and Burnout Syndrome May Predict Impaired Sleep Quality

woman sleeping
woman sleeping
The degree of overlap between MDD and burnout is unclear. However, dysfunctional sleep patterns are known risk factors for both conditions.

Sleep quality was found to be impaired in patients with major depressive disorder (MDD) and burnout syndrome (BS), according to an article published in Psychiatry Research. Patients with MDD generally had lower sleep quality than patients with BS, whereas participants with comorbid MDD and BS had the lowest sleep quality.

The degree of overlap between MDD and BS is unclear. However, dysfunctional sleep patterns are known risk factors for both conditions, although it is unknown whether sleep quality differs between MDD and BS.

The present study used data on 4415 participants (age range, 18-68 years) with full-time or part-time employment from the Dresden Burnout Study (DBS), assessed via nternet and population registry. Participants in the DBS provided information via several measures, including the Patient Health Questionnaire 9 (PHQ-9), the Maslach Burnout Inventory-General Survey (MBI-GS), and the Pittsburgh Sleep Quality Index (PSQI). The researchers categorized participants into the following groups: control (n=3245), MDD (n=395), BS (n=339), and comorbid MDD and BS (n=436). For longitudinal analysis, patients (n=1291) completed the 3 surveys after 1 to 3 years.

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The researchers performed regression analytical methods to determine associations between MDD, BS, and sleep quality, with a PSQI cutoff score >5 denoting a sleep disorder (SD).

Patients with MDD had poorer sleep quality (PSQI, 9.8; SD, 3.4) than patients with BS (PSQI, 8.2; SD, 3.1), whereas patients with both MDD and BS (PSQI, 10.7; SD, 3.2) had the worst sleep quality. This analysis showed that SD were positively associated with both MDD (odds ratio [OR], 2.59; 95% CI, 1.88-3.56, P <.001) and BS (OR, 1.57; 95% CI, 1.20-2.06, P <.01). After longitudinal analysis, MDD (OR, 2.03; 95% CI, 1.28-3.23, P <.01), but not BD (OR, 0.09; 95% CI, 0.60-1.35, P >.05), was positively associated with SD. Furthermore, SD was positively associated only with MDD (OR, 2.02; 95% CI, 1.15-3.57, P <.05), not with BS (OR, 1.15; 95% CI, 0.73-1.80, P >.05).

Limitations of the study included reliance on self-report measures rather than clinically confirmed diagnosis and potential selection bias because participants with mental health disorders may be more likely to participate.

“It might therefore be that altered biological mechanisms, such as those considered to justify the influence of [sleep quality] on major depressive syndrome, do not seem to be sufficient to induce a burnout syndrome through impaired [sleep quality],” the researchers concluded, “It might be that work-related stressors need to occur additionally to trigger a clinically relevant increase in burnout symptoms.”


Rothe N, Schulze J, Kirschbaum C, et al. Sleep disturbances in major depressive and burnout syndrome: A longitudinal analysis [published online ahead of print, February 18, 2020]. Psychiatry Res. 2020;286:112868.