Cognitive Behavioral Treatment of Insomnia and Impact on Depression outcome - Abstract
Insomnia disorder is the most prevalent sleep disorder. Insomnia symptoms can develop prior to a depressive disorder in 41%, during a depressive episode in 29%, and following the onset of a depressive episode in 29%. Historically it has been thought that insomnia disorder is a symptom of depression and if the depressive disorder is treated the insomnia will resolve. Emerging research indicates this is in fact not the case and that by not treating the insomnia disorder it may leave the patient at risk for the development or redevelopment of depression. It is already well established that cognitive behavioral therapy for insomnia (CBTI) is the standard treatment for insomnia and this treatment is effective even when insomnia is comorbid with a medical and or psychiatric condition. Emerging literature points to the use of CBTI to treat insomnia disorder and by improving sleep there is improvement in symptoms of depression despite CBTI not directly treating the depression. We report on a case of a patient that experienced chronic persistent insomnia disorder for four years and experienced onset of a depressive episode 3 years later with recent hospitalization for suicidal ideation. This case is unique in that following CBTI treatment, the patient reported improvement in depressive symptoms and also significant reduction in suicidal ideation.