Food and Behaviour Research

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Polyunsaturated fatty acids moderate the effect of poor sleep on depression risk.

Lotrich FE, Sears B, McNamara RK. (2015) Prostaglandins Leukot Essent Fatty Acids.   Nov 10. pii: S0952-3278(15)00172-6. doi: 10.1016/j.plefa.2015.10.004. [Epub ahead of print] 

Web URL: View this and related abstracts via PubMed here.


Although potentially modifiable risk factors for interferon-alpha (IFN-α)-associated depression (IFN-MDD) have been identified, it is not currently known how they interact to confer risk. In the present study we prospectively investigated interactions among poor sleep quality, high-stress, pre-existing depressive symptoms, and polyunsaturated fatty acid status.

Non-depressed hepatitis C patients (n=104) were followed prospectively during IFN-α therapy. IFN-MDD occurs in 20-40% of patients and was diagnosed using the Structured Clinical Interview of DSM-IV (SCID-IV), with incidence examined using Cox regression. Baseline Pittsburgh Sleep Quality Inventory (PSQI), Perceived Stress Scale (PSS), Beck Depression Inventory (BDI), and a range of plasma long-chain fatty acid levels were measured (gas chromatography) - focusing on the ratio of arachidonic acid (AA) to docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) (AA/EPA+DHA).

The AA/EPA+DHA ratio (Β=0.40±0.16; p=0.006), PSQI (Β=0.12±0.04; p=0.001), PSS (Β=0.07±0.02; p<0.001), and baseline BDI (Β=0.05±0.02; p<0.001) each individually predicted IFN-MDD incidence. In step-wise Cox regression eliminating non-significant variables, two interactions remained significantly predictive: PSQI*AA/EPA+DHA (p=0.008) and PSS*AA/EPA+DHA (p=0.01).

Receiver Operator Curves (ROC) were used to examine the specificity and sensitivity of IFN-MDD prediction. When sleep was normal (PSQI<5), AA/EPA+DHA was strongly predictive of IFN-MDD (AUC=91±6; p=0.002). For example, among those with AA/EPA+DHA less than the median (4.15), none with PSQI.

These data demonstrate that the AA/EPA+DHA ratio moderates the effect of poor sleep on risk for developing IFN-MDD and may have broader implications for predicting and preventing MDD associated with inflammation.


Previous research has shown that sleep problems in children are associated with low blood omega-3, and furthermore, that sleep problems were reduced following dietary supplementation with DHA.
The study reported here focused on patients receiving treatment with the drug interferon, as this is known to carry a high risk of inducing depression, and previous research has shown that this depression risk can be reduced by supplementation with omega-3 EPA/DHA. For more information on this, see: