New York: Curing insomnia in people with depression could double their chance of a full recovery, scientists are reporting. The findings, based on an insomnia treatment that uses talk therapy rather than drugs, are the first to emerge from a series of closely watched studies of sleep and depression to be released in the coming year. The new report affirms the results of a smaller pilot study, giving scientists confidence that the effects of the insomnia treatment are real. If the figures continue to hold up, the advance will be the most significant in the treatment of depression since the introduction of Prozac in 1987.
Depression is the most common mental disorder, affecting some 18 million Americans in any given year, according to government figures, and more than half of them also have insomnia. Experts familiar with the new report said that the results were plausible and that if supported by other studies, they should lead to major changes in treatment. "It would be an absolute boon to the field," said Dr Nada L Stotland, professor of psychiatry at Rush Medical College in Chicago, who was not connected with the latest research. "It makes good common sense clinically," she continued. "If you have a depression, you're often awake all night, it's extremely lonely, it's dark, you're aware every moment that the world around you is sleeping, every concern you have is magnified."
The study is the first of four on sleep and depression nearing completion, all financed by the National Institute of Mental Health. They are evaluating a type of talk therapy for insomnia that is cheap, relatively brief and usually effective, but not currently a part of standard treatment. The new report, from a team at Ryerson University in Toronto, found that 87 percent of patients who resolved their insomnia in four biweekly talk therapy sessions also saw their depression symptoms dissolve after eight weeks of treatment, either with an antidepressant drug or a placebopill — almost twice the rate of those who could not shake their insomnia. Those numbers are in line with a previous pilot study of insomnia treatment at Stanford.
Doctors have known for years that sleep problems are intertwined with mood disorders. But only recently have they begun to investigate the effects of treating both at the same time. Antidepressant drugs like Prozac help many people, as does talk therapy, but in rigorous studies the treatments, administered individually, only slightly outperform placebo pills. Used together the treatments produce a cure rate — full recovery — for about 40 percent of patients. Adding insomnia therapy, however, to an antidepressant would sharply lift the cure rate, Dr Carney's data suggests, as do the findings from the Stanford pilot study, which included 30 people.
