It seems I can’t read an article about depression without insomnia being mentioned or an article about insomnia without depression being mentioned.
It is generally recognized that people suffering from depression may as a result suffer from insomnia. Also that people suffering from ongoing insomnia often suffer from depression.
So I set out to try and discover if the two conditions are coexisting how do we know if it is the depression causing insomnia or the insomnia causing depression and will treating one successfully treat the other.
Of course I found a myriad of articles written on the subject.
A study by clinical Psychologist Dr David Morawetz was conducted with a group of patients who suffered from chronic insomnia, of which two thirds also suffered from depression. These patients were subjected to a 6-8 week self help program (Sleep Better Without Drugs) to help improve their sleep. Using strict evaluation criteria 87 % of subjects were sleeping significantly better at follow up and 70% of those who were depressed before treatment were no longer, or significantly less, depressed. Of those who did not learn to sleep better none experienced a significant reduction in depression.
His conclusion was that for patients that suffered from both chronic insomnia and depression successfully treating the insomnia (in this case without medication) can eliminate or significantly reduce the depression.
“Sleep disturbances are a hallmark of depression, but insomnia can actually unleash the mood disorder. Treating sleep disturbances might help prevent depressive episodes”. (Hara Estroff Marano, July 01,2003)
In the past most experts agreed that depression caused insomnia but new (drug) treatments to improve depression did not seem to alleviate insomnia, supporting the idea that insomnia could be a contributor or predictor of depression (interestingly the elderly being most at risk).
A longitudinal study by Michael Perlis PhD (University of Rochester Sleep Research Laboratory) showed that insomnia appears to precede episodes of depression by about 5 weeks suggesting it may be more than just a symptom of depression but may actually unleash the mood disorder.
His studies showed that people most at risk of depression are those patients with severe “middle insomnia” described as waking up frequently during the night but eventually falling back to sleep each time…really quite a common occurrence amongst the population. He says the findings are especially significant because they suggest that targeted treatment for insomnia will increase the likelihood and speed of recovery from depression.
Given the connection has been made between insomnia and depression, trials and studies into improving sleep patterns are continually being conducted.
Often people are unaware of the consequences of disturbed sleep patterns, including insomnia, and their possible relationships to other conditions, hence may not seek treatment.
Just to confuse the issue evidence from other research also suggests that in a certain proportion of depression sufferers insomnia has an antidepressant effect (apparently all to do with the serotonin and dopamine neurotransmitter systems).
Irene
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