November 20, 2013
News Review From Harvard Medical School -- Treating Insomnia May Cure Depression
Treating insomnia significantly improves depression, a study finds. The study included 66 patients. They received 4 sessions of talk therapy over 8 weeks. During these session, patients got specific instructions on how to improve their insomnia. They did not get sleep medicines. After two months, patients who slept better after the therapy showed a significant improvement in their symptoms of depression. Poor sleep can lead to depression. And depression can cause insomnia. This study suggests that insomnia may contribute to depression. Researchers from Ryerson University in Toronto conducted the study. It has not yet been published. It was funded by the National Institutes of Mental Health (NIMH). This study confirms the findings of another small study. Other studies on sleep and depression are under way. They are also funded by the NIMH. HealthDay News and The New York Times wrote about it November 19.
By Howard LeWine, M.D.
Harvard Medical School
What Is The Doctor's Reaction?
Insomnia is one of the most common types of sleep disturbance, at least occasionally affecting about one in three Americans. People with insomnia may have trouble falling asleep, staying asleep, poor quality of sleep and sometimes a combination of all three.
Sleep problems are particularly common in people with depression. The general assumption has been that the depression leads to insomnia. However, some recent research suggests that insomnia often precedes the onset of depression. It’s not known yet if insomnia can cause depression. But it is likely an important contributing factor.
Recently, some small studies used talk therapy directed at insomnia rather than depression. The results show that it helped improved depression scores. For some, the changes were quite dramatic. Sleep drugs were not prescribed.
These study results are preliminary. They have not yet been published in a peer-reviewed journal.
What Changes Can I Make Now?
You may not be concerned about depression. But not getting enough good sleep can interfere with your enjoyment of life, your performance at work and relationships at home.
Here are some ways to help you get better sleep:
- Establish a regular bedtime and a relaxing bedtime routine. Examples might include taking a warm bath or listening to soothing music.
- Use your bed only for sleeping or lovemaking. Avoid reading and watching television in bed.
- If you can't sleep after 15 to 20 minutes, get out of bed and go into another room. Read quietly with a dim light. Don't watch television, since the light from the TV has an arousing effect. When you feel sleepy, get back into bed. Don't delay your scheduled wake-up time to make up for lost sleep.
- Get plenty of exercise. Build up to 45 minutes of moderate exercise nearly every day. Get your exercise early in the day. Try some easy stretching exercises or yoga to relax your muscles and your mind at bedtime.
- Whenever possible, schedule stressful or demanding tasks early in the day and less challenging activities later. This helps to wind down at the end of your day.
- Adjust what you eat and drink.
- Don't go to bed hungry, but don't eat a big meal right before getting into bed. If you want a bedtime snack, keep it bland and light.
- Limit caffeine and consume none after 2 p.m.
- To decrease middle-of-the-night urination, don't drink any fluids after dinner.
- Avoid alcohol after dinnertime. Although many people think of it as a sedative, it can actually impair your sleep.
- Be sure your bed is comfortable and your bedroom is dark and quiet. Consider a sleep mask or earplugs.
- Don't let yourself get overheated. Keep the bedroom at a constant, comfortable temperature.
- Don't take long naps during the day. If you need a nap, restrict it to 20 to 30 minutes in the early afternoon.
- Turn the alarm clock around so you won't worry that you are still awake.
- Practice relaxation breathing. Use slow breaths, especially when you exhale.
What Can I Expect Looking To The Future?
We will need larger studies to determine whether inadequate sleep time and/or poor quality sleep can directly lead to depression. But if you have any symptoms of depression, even mild ones, there is no downside to practicing good sleep hygiene. And you may find it greatly improves how you feel.