How can insomnia be treated to prevent depression in older adults?
Older people’s depression is rather prevalent. Major depressive disorder (MDD) affects an estimated 10 per cent of persons over the age of 60 in the United States. The symptoms of MDD include depressed mood, loss of interest in pleasurable activities, difficulty concentrating, feelings of worthlessness and guilt; thoughts of death or suicide; exhaustion; sleep disturbances; unplanned weight loss or gain; and slowed or agitated movement. MDD is a mental illness that has no cure.
What is the connection between depression and sleep?
When a person has MDD, they’re more likely to suffer from both insomnia and hypersomnia, the inability to fall or stay asleep, as well as getting up too early. Insomnia has been shown to more than double one’s chances of developing MDD. To put this in perspective: A recent study found that more than 70 per cent of persons aged 65 and older reported experiencing some form of insomnia, making this particularly relevant to older adults.
Is insomnia therapy a viable strategy for preventing depression?
Treating insomnia in patients with both insomnia and MDD has the potential to enhance both sleep and mood, according to emerging data Study participants with insomnia and MDD were given cognitive behavioural therapy for insomnia, as an example from Australia (CBT-I). CBT-I is a subset of cognitive and behavioural therapy that focuses solely on treating insomnia in patients, as opposed to other disorders for which the same techniques are often employed, such as depression. Patients with insomnia will not benefit from CBT for depression since the techniques they learn will not work for them. Study participants who underwent CBT-I from a behavioural sleep medicine expert felt better and their depressive symptoms reduced so much that their MDD was determined to be in remission, even though they had only received insomnia-focused therapy.
Insomnia treatment can be used to prevent depression in older persons.
JAMA Psychiatry recently released a study on whether CBT-I could prevent the onset of MDD in persons over 60. The trial involved 291 people who had been diagnosed with insomnia disorder within the previous year but had not been diagnosed with MDD. Randomly assigned individuals were given CBT-I treatment from a clinical psychologist or a public health educator who provided the study’s control condition, depending on which treatment they received. Study participants were monitored every six months for a total of three years to see if they acquired MDD.
So, what were the findings?
Of those who were followed for three years after receiving CBT-I, 12% acquired MDD, whereas 26% of those who were merely given sleep instruction got MDD. A statistical technique was then utilised to examine the effect of baseline depressive symptoms and antidepressant and hypnotic drug usage. According to the researchers, there was a “almost 60% decrease in the likelihood of depression.” When insomnia was healed in CBT-I receivers, only 5% developed MDD, compared to 15% of CBT-I recipients who didn’t have their insomnia fixed.
I’m not sure what this means to me.
People are becoming more interested in the concept of preventative medicine, which focuses on healthy habits to stave off disease rather than treating symptoms as they arise. For those suffering from insomnia as a result of a pandemic, many people, even the elderly, may find that CBT-I can serve as a preventative measure against MDD as well as provide numerous other benefits.
A CBT-I specialist should be sought out when looking for a provider and should not be confused with “sleep advice” or “sleep hygiene” programmes. Many specialists are now giving telemedicine treatment, which may be accessed through online directories.
