Depression is common among people over the age of sixty-five. Some estimates suggest that the prevalence of major depressive disorder (MDD) among adults over the age of 60 has been estimated at more than 10% in the past year. Anxiety, depression, and difficulty concentrating are all signs and symptoms of MDD. Other signs and symptoms of MDD include fatigue, sleep disturbances, unplanned weight loss or gain, or a change in appetite, as well as slowed or agitated movement. MDD is a mental illness that affects the brain’s reward system.

What is the relationship between sleep and depression?

Having MDD is associated with insomnia (difficulty falling asleep, staying asleep, and/or waking up too early) as well as hypersomnia (sleeping excessive amounts of time). In particular, insomnia increases the likelihood of developing MDD twofold. This is especially important for older adults, as one study found that more than 70% of adults over the age of 65 reported experiencing at least one symptom of insomnia.

Why study insomnia treatment to prevent depression?

The evidence that insomnia treatment in individuals who are suffering from both insomnia and MDD is growing, and it has the potential to enhance both sleep and mood in these patients is becoming more compelling. Participants in one study done in Australia with insomnia and MDD were treated with cognitive behavioral treatment for insomnia, which is a type of cognitive behavioral therapy (CBT-I). CBT-I is a unique collection of tools developed to assist patients in treating only their insomnia. It is separate from other domains where cognitive and behavioral methods are routinely employed in treatment, such as depression, and is intended to help patients treat only their insomnia. This means that the tactics that a patient could learn while receiving cognitive behavioral therapy (CBT) for depression would not be useful for people suffering from insomnia. A study found that 61 per cent of patients who underwent CBT-I from a behavioral sleep medicine expert felt better, and many symptoms of their depression improved—to the point where they were categorized as being in remission from major depressive disorder (MDD).

Preventing MDD in elderly people by treating their sleeplessness:

Adults over 60 were studied to see if CBT-I may help prevent the onset of MDD in a study published in the journal JAMA Psychiatry. The trial involved 291 people who had been diagnosed with insomnia disorder but had not been diagnosed with MDD in the previous 12 months as part of a larger study. Clinical psychologists with experience in this area were randomly assigned to give CBT-I to study participants, while public health educators were assigned to provide sleep instruction as the study’s control condition. For three years, the study participants were observed every six months to see if they acquired MDD.

Their research yielded what?

The researchers found that 12 per cent of participants who got CBT-I developed MDD throughout the three-year follow-up period, whereas 26 per cent of participants who had just received a sleep education programme developed MDD. Afterwards, the researchers employed a statistical approach to determine whether the severity of any moderate depressive symptoms present at baseline, as well as the usage of antidepressant and hypnotic medicines, had an impact. They concluded that there was an “almost 60% reduction in the chance of developing depression.” We should also note, however, that among study participants who received CBT-I, sleep appeared to play a role as well: only 5 per cent of CBT-I recipients developed MDD if their insomnia had been successfully treated, compared to 15 per cent of CBT-I recipients whose insomnia had not been successfully treated.

In Terms Of My Situation, What Does This Mean?

There is a growing interest in preventive medicine, which is defined as focusing on health practices to avoid disease rather than merely treating health problems when they manifest themselves. Amid a pandemic when many people, including older adults, may be struggling with their moods, it appears that those suffering from insomnia disorder may want to consider cognitive behavioral therapy for insomnia as a preventative measure against major depressive disorder (MDD), in addition to the many other benefits of treating insomnia.

When looking for a provider, it is critical to ensure that they specialize in CBT-I and that they do not confuse sleep recommendations or “sleep hygiene” with a comprehensive CBT-I treatment programme. There are internet directories of specialists that might serve as a starting point for interested people, with many of them now offering telemedicine services.