Cognitive Behavioral Therapy for Insomnia Helps Prevent Major Depression

Rates of major depression lower among older adults with insomnia disorder who underwent CBT versus sleep education therapy

WEDNESDAY, Dec. 8, 2021 (HealthDay News) — Cognitive behavioral therapy for insomnia (CBT-I) has an overall benefit in the prevention of incident and recurrent major depression in older adults with insomnia disorder, according to a study published online Nov. 24 in JAMA Psychiatry.

Michael R. Irwin, M.D., from University of California in Los Angeles, and colleagues examined whether treatment of insomnia disorder with CBT-I versus sleep education therapy (SET; active control) prevents major depressive disorder in older adults. The analysis included 291 participants randomly assigned to two months of CBT-I (156 participants) or SET (135 participants) and 24 months of follow-up.

The researchers found that incident or recurrent major depression occurred in 19 participants (12.2 percent) in the CBT-I group and in 35 participants (25.9 percent) in the SET group, with an overall benefit (hazard ratio, 0.51) consistent across subgroups. In CBT-I participants, remission of insomnia disorder continuously sustained before a depression event or during follow-up was more likely versus the SET participants (26.3 versus 19.3 percent). There was an 82.6 percent decreased likelihood of depression among those in the CBT-I group with sustained remission of insomnia disorder (hazard ratio, 0.17) versus the SET group without sustained remission of insomnia disorder.

“Community-level screening for insomnia concerns in older adults and wide delivery of CBT-I-based treatment for insomnia could substantially advance public health efforts to treat insomnia and prevent depression in this vulnerable older adult population,” the authors write.

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