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CBT-I Halves Likelihood of Depression in Older Adults
Cognitive behavioral therapy for insomnia (CBT-I) is beneficial for preventing incident and recurrent depression in older adults with insomnia disorder, according to findings published in JAMA Psychiatry.
“Given that older adults account for nearly 20% of the US population and are the most vulnerable for health risks associated with depression, effective depression prevention is urgently needed,” said study lead author Michael Irwin, MD, professor of psychiatry and biobehavioral sciences at the David Geffen School of Medicine at University of California, Los Angeles. “Insomnia more than doubles the risk for major depression. By targeting insomnia and effectively treating it with CBT-I, depression can be effectively prevented by over 50% in community-dwelling older adults with insomnia.”
The trial randomized 291 adults 60 years or older to CBT-I or an active comparator condition, sleep education therapy. While CBT-I helps recipients identify and change inaccurate or distorted thinking patterns, emotional responses, and behaviors, sleep education therapy teaches about sleep and healthy sleep habits. Participants received weekly 120-minute group sessions of their assigned intervention over 2 months.
During 36 months of follow-up, monthly questionnaires gauged symptoms of depression and insomnia in participants, and diagnostic interviews to assess for clinical depression occurred every 6 months.
Over follow-up, depression occurred in 25.9% of older adults in the sleep education therapy group compared with in 12.2% of older adults in the CBT-I group—a 51% difference, researchers reported.
Furthermore, sustained insomnia remission was more likely in the CBT-I group compared with the sleep education therapy group. Participants who received CBT-I and experienced sustained insomnia remission had an 82.6% decreased likelihood of depression compared with participants in the sleep education therapy group without sustained insomnia remission.
“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,” researchers advised. “These data support further efforts to prevent depression by targeting risk factors such as insomnia disorder with the potential to maximize efficacy of depression prevention.”
References
New study shows that treating insomnia with cognitive behavioral therapy can prevent major depression in older adults. News release. University of California, Los Angeles, Health Sciences. November 24, 2021. Accessed December 13, 2021.
