Severe sleep disturbance is associated with executive function impairment in patients with first-episode, treatment-naïve major depressive disorders

BACKGROUND: Sleep disturbance and executive function impairment are common in patients with major depressive disorder (MDD), though the relationship between the two remains unclear. We investigated this association in first-episode, treatment-naïve patients with MDD. METHODS: We analyzed data from 242 patients with MDD. We divided the patients into 2 groups based on sleep disturbance severity and compared the executive function odds ratios between the groups. RESULTS: A total of 121 pairs of patients were matched (age 39.4 ± 10.1, 70.2% female). After propensity score matching, the odds ratios for cognitive impairment in patients with MDD and severe sleep disturbance were 1.922 (1.068–3.459, P = 0.029, q = 0.044) in executive functioning; 2.023 (1.211–3.379, P = 0.007, q = 0.021) in executive shifting. CONCLUSIONS: Sleep disturbance is associated with executive functioning impairment in first-episode, treatment-naïve patients with MDD. Severe sleep disturbance can be a marker and aid in recognizing executive function impairment in patients with first-episode treatment-naïve MDD. Severe sleep disturbance can be a potential modifiable factor to improve executive function in MDD, as well as an effective measurement to improve cognition for sleep symptom management that should be enforced at initial treatment of first-episode MDD. Further study is required to confirm our results. TRIAL REGISTRATION: ClinicalTrials.gov: NCT02023567; registration date: December 2013. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-021-03194-2.