Can we prevent depression in older adults by treating insomnia?

February 16, 2022

illustration of an older man with insomnia in bed looking at clock trouble sleeping

Depression is common among older adults. By some estimates, more than 10% of adults over the age of 60 have struggled with major depressive disorder (MDD) within the past year. There are a number of symptoms of MDD, including depressed mood, loss of interest in pleasurable activities, difficulty concentrating, thoughts of worthlessness or guilt, thoughts of death or suicide, fatigue, sleep disturbances, unplanned weight loss/gain or a change in appetite, and slowed or agitated movement.

Both insomnia (difficulty with falling asleep, staying asleep, and/or waking too early) and hypersomnia (sleeping excessive amounts) are common in someone who has MDD. Notably, insomnia doubles the risk of MDD. This is of particular significance for older adults, as one study revealed that over 70% of adults over 65 reported at least one symptom of insomnia.

Why would researchers investigate insomnia treatment as a way to prevent depression?

There is increasing evidence that treating insomnia in patients who are suffering from both insomnia and MDD has the potential to improve both their sleep and mood. For example, in one study conducted in Australia, study participants with insomnia and MDD were treated with cognitive behavioral therapy for insomnia (CBT-I). CBT-I is a specific set of tools designed to help patients treat only their insomnia, and is distinct from other domains where cognitive and behavioral strategies are commonly used in treatment, such as depression. This means that the strategies one might learn when receiving CBT for depression would not help patients with insomnia. Despite receiving only insomnia-focused therapy, 61% of study participants who had received CBT-I from a behavioral sleep medicine expert felt better, and many symptoms of their depression improved — so much so that their MDD was considered to be in remission.

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