Is Curing Insomnia Key to Curing Depression?

A New York Times editorial called it possibly "the most dramatic advance in treating depression in decades."

Psychologist and sleep specialist Michael Breus, writing in the Huffington Post, said it could "dramatically change and broaden treatment for millions of people who suffer the debilitating effects of depression."

The excitement is over a new report that found that treating insomnia along with depression could double a person's chance of overcoming the mood disorder. Even more surprising, patients' insomnia was treated not with medication, but with just four sessions of an intense form of talk therapy called cognitive behavioral therapy for insomnia, or CBT-I.

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The findings are based on a small study, reported the Times, but scientists are hopeful that an ongoing series of sleep-and-depression studies, due to be released in the coming year, will confirm these results. If so,  it could result in the biggest change in depression treatment since the antidepressant Prozac was introduced in 1987, according to the Times.

The research represents a significant change in how doctors view the link between insomnia and depression. The assumption had been that depression causes insomnia, but it could be that insomnia occurs first and contributes to depression or is an early warning sign of depression.

The study of 66 patients by researchers at Ryerson University in Toronto, and funded by the U.S. National Institute of Mental Health, found that 87 percent of patients who cured their insomnia after four CBT-I sessions over eight weeks also saw their depression symptoms fade - almost twice the rate of those whose insomnia wasn't cured. Similar results were found in a 2008 pilot study of insomnia treatment at Stanford University.

The CBT-I sessions give patients specific instructions they must follow: Set a regular wake-up time and stick to it; get out of bed if you're awake; don't eat, read or watch TV in bed; and avoid taking daytime naps.

Although covered by insurance at about the same rate as for psychotherapy, CBT-I is not widely available. This research could change that. Lead author Colleen Carney, director of the sleep and depression lab at Ryerson, said the therapy is easy to teach. "In the study we did, I trained students to administer the therapy," she told the Times.

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The American Psychological Association last year recognized sleep psychology as a specialty, and the Department of Veterans Affairs has begun a program to train about 600 sleep specialists, the Times reported.

About 20 million Americans, primarily those 45 and older, suffer from depression and more than half also suffer from insomnia, according to government figures. The fact that a simple, low-cost therapy seems to have been so effective holds out new hope to millions.

 

Photo: Diane39/iStock

 

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