Addressing Insomnia Seems to Alleviate Depression — Physician’s First Watch
Addressing Insomnia Seems to Alleviate Depression
By Joe Elia
Patients may ask about reports on the use of cognitive behavioral therapy to resolve insomnia, especially because the approach also seems to enhance the effectiveness of antidepressants. More than half of Americans with depression also suffer from insomnia, according to the New York Times.
Two Times reports describe a technique — not yet widely available but easily taught — called CBT-I (or cognitive behavioral therapy for insomnia). It involves about four sessions that emphasize control of stimuli around bedtime and keeping a sleep diary. Tactics include avoiding eating or watching television in bed, and getting up at the same time each day. If needed, cognitive therapy to challenge self-defeating thoughts (e.g., "If I don't sleep well, I can't function the next day") is added.
Four small studies under way use the technique as part of treating patients with depression. A preliminary report found that almost 90% of patients whose insomnia resolved after 8 weeks of CBT-I also had resolution of depression after 8 weeks of treatment with either an antidepressant or a placebo.