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Insomnia a potential therapeutic target in depression

11 Jun 2018

Guided online Cognitive Behavioral Therapy for Insomnia (CBT-I) may be used in the management of both insomnia and depressive symptoms, with effect sizes being large and comparable to that of depression therapy, according to a study.

The study randomized 104 individuals (mean age 45.99 years; 82 percent female) with clinical insomnia and at least subclinical depression levels to interventions comprising guided online CBT-I and sleep diary monitoring (i-Sleep; n=52) or sleep diary monitoring only (control; n=52).

I-Sleep consisted of five sessions focused on (1) sleep hygiene and lifestyle, (2) stimulus control and sleep restriction therapy aimed at increasing the time in bed (TIB) spent asleep and decreasing TIB spent awake, (3) relaxation, (4) cognitive therapy tackling dysfunctional thoughts about sleep, and (5) relapse prevention.

Severity of depressive symptoms (Patient Health Questionnaire-9 without sleep item; PHQ-WS) was the primary study outcome. Secondary outcomes included insomnia severity, sleep diary parameters, fatigue, daytime consequences of insomnia, anxiety and perseverative thinking.

After the intervention, participants in the i-Sleep arm reported significantly less depressive symptoms (PHQ-WS) compared with those in the control arm.  I-Sleep also yielded large significant effects for insomnia severity (d=2.36), most sleep diary parameters, daytime consequences of insomnia, anxiety and perseverative thinking. Effects persisted at 3- and 6-month follow-up.

On the other hand, no significant effects were seen on fatigue or total sleep time.

The present data suggest that insomnia requires dedicated attention and may serve as a novel target in the treatment of depression, researchers said. Further work is crucial to elucidate the specific relations between insomnia and depression symptoms, in patients with a clinical diagnosis of both to optimize therapeutic effects and improve clinical outcomes.
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Most Read Articles
Stephen Padilla, 2 days ago
Treatment with oral thrombopoietin receptor agonist eltrombopag leads to similar platelet counts in patients with chronic immune thrombocytopaenia (cITP) and persistent (per)ITP, according to the results of phase III (EXTEND) and IV studies presented at the 23rd Congress of the European Hematology Association (EHA 2018) held in Stockholm, Sweden.
Pearl Toh, 4 days ago
Lonely people were twice as likely to die from any cause than people who did not feel lonely, according to a study based on a national survey presented at the recent EuroHeartCare 2018 in Dublin, Ireland. Also, loneliness is associated with poorer patient-reported outcomes in terms of mental and physical health in patients with heart disease.
15 Jun 2018
Higher activity of plasma xanthine oxidase appears to be linked to insulin resistance and liver dysfunction among type 2 diabetes mellitus (T2DM) patients with metabolic syndrome (MetS), according to a recent Japan study.
Jairia Dela Cruz, 2 days ago
A treatment regimen combining daratumumab plus bortezomib, melphalan and prednisone markedly extends progression-free survival in patients with multiple myeloma, inducing deep responses and demonstrating acceptable tolerability regardless of baseline renal function, according to the results of the phase III ALCYONE study.