From Our 2013 Archives
Insomnia Cure Boosts Success of Depression Treatment, Study Finds
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Doctors have long reported a link between insomnia -- the inability to sleep -- and depression, but many thought that depression led to insomnia. Now, experts suspect sleep problems can sometimes precede depression.
If other ongoing studies confirm these results, it might lead to major changes in depression treatment, experts added. Such changes would represent the biggest advance in depression treatment since the antidepressant Prozac was introduced in 1987, The New York Times reported.
"The way this story is unfolding, I think we need to start augmenting standard depression treatment with therapy focused on insomnia," Colleen Carney, lead author of the small study, told the Times.
The study was funded by the U.S. National Institute of Mental Health.
The insomnia treatment relied on talk therapy, rather than sleep medication, for 66 patients.
Insomnia and depression are both common problems, and often interact, explained Dr. Steven Feinsilver, director of the Center for Sleep Medicine at Mount Sinai School of Medicine in New York City. He was not involved in the study.
"Clearly, poor sleep can cause depression and depression can cause poor sleep," he said.
Evidence does exist that for many people, symptoms of insomnia precede symptoms of depression by a few years, Feinsilver noted. "This could be taken to mean either that insomnia causes depression or that insomnia is the earliest symptom of depression," he said.
This study may help untangle that relationship. It "suggests that specifically treating the insomnia with behavioral techniques can substantially improve the outcome of patients with depression," Feinsilver added.
For the millions of people with depression, the findings offer a ray of hope.
"This relatively simple technique for treating insomnia could be tremendously helpful for those with this common psychiatric illness," Feinsilver said.
More than 20 million Americans suffer from depression -- disabling feelings of sadness and despair that don't go away, according to the U.S. National Library of Medicine. More than half of those with depression also suffer from insomnia.
The research team, from Ryerson University in Toronto, found depression lifted significantly among patients whose insomnia was cured. The insomnia treatment consisted of four talk therapy sessions over eight weeks, according to the Times.
During the sessions, patients were given certain instructions: set a specific wake-up time and don't veer from it; get out of bed when awake but don't eat, read or watch TV; and refrain from taking any daytime naps.
Almost 90 percent of patients who responded to the insomnia therapy also saw their depression lift after taking an antidepressant pill or an inactive placebo for two months. That was about double the rate of those who could not shake their sleeplessness, the news report said.
Study participants had to have had a month of sleep loss that had an effect on their jobs, family life or other relationships.
A smaller pilot study conducted at Stanford University produced similar findings, the Times reported.
Carney was to present the latest research Saturday at a conference of the Association for Behavioral & Cognitive Therapies, in Nashville, Tenn., the newspaper reported.
Research presented at meetings should be viewed as preliminary until published in a peer-reviewed medical journal.
SOURCES: Steven Feinsilver, M.D., director, Center for Sleep Medicine, senior faculty, Mount Sinai School of Medicine, New York City; Nov. 18, 2013, The New York Times