Insomnia is a common sleep disorder that affects people of all ages, but it is more common among older adults. Depression is a common mental disorder that affects people of all ages, but it is more common among older adults. According to the World Health Organization (WHO), depression is the leading cause of disability worldwide and a major contributor to the overall burden of disease. Depression can have a significant impact on the quality of life, social functioning, and physical health of older adults.
Cognitive Behavior Therapy for Insomnia (CBT-I) is a non-pharmacological approach that aims to change behaviors and thoughts related to sleep problems. It typically involves several sessions with a therapist who helps patients develop a set of skills to improve their sleep quality. These skills include sleep hygiene, relaxation techniques, and sleep restriction therapy. Unlike medication, CBT-I has no side effects and has a lasting effect on sleep quality.
According to a recent clinical trial, treatment of insomnia with CBT-I can prevent depression in community-dwelling adults aged 60 years or older without depression but with insomnia.
The trial involved 291 older adults with insomnia disorder who were randomly assigned to either 2 months of CBT-I or sleep education therapy (SET). The primary outcome was time to incident major depressive disorder as diagnosed by interview and Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) criteria. The secondary outcome was sustained remission of insomnia disorder before the depression event or duration of follow-up.
The study showed that when adults with insomnia received cognitive behavioral therapy for insomnia and their insomnia went away and stayed away, they were less likely to become depressed compared to those who received sleep education therapy (SET) and did not experience sustained insomnia remission.
Specifically, out of the participants who received CBT-I, 19 (12.2%) developed incident or recurrent major depression, while 35 (25.9%) in the SET group did. This means that the overall benefit of CBT-I was consistent across different groups and the likelihood of depression was reduced by 51% in the CBT-I group compared to the SET group.