Sleep duration predicts treatment success in comorbid insomnia, depression

Individuals with comorbid insomnia and depression who slept 7 hours or more and received CBT for insomnia were significantly more likely to achieve remission, according to recent findings.

“A seven-hour, objective sleep duration of patients prior to entering treatment increased their chances of achieving both depression and insomnia remission by their treatment endpoints,” study researcher Jack D. Edinger, PhD, of the National Jewish Health in Denver, said in a press release.

To determine if sleep duration moderates treatment response in comorbid depression and insomnia, researchers evaluated 104 study participants from the Treatment of Insomnia and Depression Study (TRIAD). Study participants completed 1 night of polysomnography at baseline then were randomly assigned to receive 16 weeks of antidepressant medication plus a CBT for insomnia (CBTi) or a control therapy. Hamilton Rating Scale for Depression (HAMD-17) and Insomnia Severity Index were administered at baseline and biweekly during treatment. Logistic regressions were conducted at sleep duration cutoffs of 5, 6, and 7 hours.

Insomnia remission was more common among participants who received CBTi and 5 hours of sleep or more (OR = 4.5; 95% CI, 1.6-12.7), compared with controls with 5 hours of sleep or more and participants who received CBTi with shorter sleep (OR = 11.8; 95% CI, 1.4-101.7).

Outcomes did not differ among participants who received CBTi or control with less than 5 hours of sleep.

Seven hours of sleep was a significant predictor of insomnia (P = .02) and depression (P = .04) remission in participants who received CBTi.

Depression remission occurred in 62.5% of participants who received CBTi and 7 or more hours of sleep, compared with remission rates ranging from 18.2% to 42.1% in other subgroups.

“Our findings highlight the importance of adequate objective sleep in the recovery from depression and insomnia,” study researcher Rachel Manber, PhD, of Stanford University Medical Center, said in the release. “The data suggest that short sleep duration may be a risk for refractory depression.” – by Amanda Oldt

Reference:

Edinger J, et al. Does objective sleep duration moderate treatment response in patient with comorbid depression and insomnia? A report from the TRIAD study. Presented at: American Academy of Sleep Medicine Annual Meeting; June 3-7, 2017; Boston.

Disclosure: Please see the study for a full list of relevant financial disclosures.