Thursday, February 17, 2022

Can insomnia treatment be used to prevent depression in older adults?

Is treating insomnia a good way to prevent depression in elderly people?

Depression is very common among the elderly. According to some estimates, more than 10% of people over the age of 60 had experienced major depressive disorder (MDD) in the previous year. Those who suffer from depression may find it difficult to look forward to activities that they used to find enjoyable. You might have difficulties concentrating, feel useless or guilty, and consider suicide. You might also be tired or have a change in your appetite.

What's the connection between sleep and depression?

In someone with MDD, both insomnia (difficulty going to sleep, staying asleep, and/or waking up too early) and hypersomnia (sleeping excessively) are prevalent. Insomnia, in particular, doubles the risk of MDD. This is especially important for the elderly, as a recent study found that more than 70% of people aged 65 and older reported experiencing at least one insomnia symptom.

Scientists are investigating insomnia therapy as a way to avoid depression for a variety of reasons

According to emerging data, treating insomnia in patients with both insomnia and MDD has the potential to enhance both sleep and mood. Participants with insomnia and MDD were treated with cognitive behavioral therapy for insomnia in one trial done in Australia (CBT-I). CBT-I is a set of tools designed to help patients treat only their insomnia, as opposed to other disorders where cognitive and behavioural strategies are commonly used, such as depression. There is a good chance that people who get CBT for depression can't use the strategies they learn to help them sleep. 61% of people who got CBT-I from a behavioural sleep medicine expert said that they felt better, and some symptoms of depression improved a lot – to the point where their MDD was declared to be in remission.

Preventing major depressive disorders in older adults through insomnia treatment

Adults over the age of 60 were studied to see if CBT-I may help prevent the start of MDD in a study published in JAMA Psychiatry. The trial involved a total of 291 participants who fulfilled diagnostic criteria for insomnia disorder but did not satisfy diagnostic criteria for MDD in the preceding 12 months. Participants were randomly assigned to receive either CBT-I from a clinical psychologist with experience in this area or a control condition consisting of a sleep education program from a public health educator. The research team followed study participants for a total of three years, every six months, to assess whether they had MDD.

What were the findings of their research?

In a three-year follow-up study, 13% of individuals who underwent CBT-I developed MDD, compared to 26% of participants who just received a sleep education program. The researchers next employed a statistical approach to examine the effect of the severity of moderate depressive symptoms at baseline and the usage of antidepressant and hypnotic medicines. They determined that there was an "almost 60% reduction in depression risk." It is worth noting that sleep appeared to play a role among study participants who got CBT-I: Only 5% of CBT-I recipients acquired MDD if their insomnia was healed, compared to 15% of CBT-I recipients whose insomnia was not addressed.


What does this imply for me personally?

There is a growing interest in preventive medicine, which emphasizes health practices as a means of preventing disease rather than treating symptoms as they occur. In the event of a pandemic, when many individuals, particularly older folks, may be dealing with their mood, it appears that those with insomnia issues may want to explore CBT-I as a possible preventative measure against MDD, in addition to the numerous other benefits of treating insomnia.
When looking for a provider, it is critical to ensure that they specialize in CBT-I and do not mistake sleep advice or "sleep hygiene for a comprehensive CBT-I treatment program. There are internet listings of professionals that can put interested people in the right direction, with many now offering telemedicine treatment.


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