Sleep Duration Linked to Tx Response in Depressed Patients with Insomnia
Patients with comorbid depression and insomnia who sleep ≥7 hours per night are more likely to experience depression remission through cognitive behavior therapy for insomnia (CBTI), according to new study data presented at SLEEP 2017.
Having a longer pre-treatment objective sleep duration is thought to predict remission of both depression and insomnia when patients are treated with an antidepressant and CBTI together. Lead author, Jack D. Edinger, PhD, from the Section of Sleep Medicine at National Jewish Health, Denver, CO, explained that a 7-hour sleep duration in patients before starting treatment raised their likelihood of achieving remission in depression and insomnia by their treatment endpoints.
The study (n=104) included patients enrolled in The Treatment of Insomnia and Depression Study who completed one baseline night of polysomnography. The patients all received antidepressant therapy for 16 weeks and were randomized to either CBTI or sham insomnia therapy. They were given the Hamilton Rating Scale for Depression (HAMD-17) and Insomnia Severity Index at baseline and then biweekly during treatment to assess remission.
Patients in the CBTI group with ≥7 hours of sleep per night demonstrated a 62.5% depression remission rate. The remission rates for the other subgroups ranged from 18.2% to 42.1%.
Findings from the study suggest that a shorter sleep duration may be a risk factor for refractory depression. The data further "highlight the importance of adequate objective sleep in the recovery from depression and insomnia," added Rachel Manber, PhD, from Stanford University Medical Center.
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Edinger JD , Manber R , Krystal AD , Buysse DJ. Does Objective Sleep Duration Moderate Treatment Response in Patient With Comorbid Depression and Insomnia? A Report From the TRIAD Study. SLEEP 2017. Abstract ID 0335. June 2017.