Sleep and depression have a complex relationship. In some cases depression can cause sleep problems, such as insomnia, and in other cases sleep problems contribute to depression. Sleep issues and depression share common risk factors, and certain treatments can relieve symptoms of both. As researchers delve more into this relationship, new understanding of the conditions could lead to new treatments.
Who is at risk?
Though depression – and sleep problems for that matter – can affect anyone, certain people are more susceptible, including women and older adults. Higher rates of depression and sleep problems are reported in older adults likely due to illness. For women, hormonal changes due to menopause, pregnancy and menstruation can contribute to depression. It’s also possible that within these two groups, higher rates of insomnia actually cause higher rates of depression.
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How are insomnia and depression linked?
According to the National Sleep Foundation, studies have shown that people who experience insomnia are 10 times more likely to become depressed compared with those who consistently get good sleep. In addition, people who are depressed have a higher frequency of experiencing insomnia. The symptoms can include difficulty falling asleep, difficulty staying asleep, not getting deep sleep and daytime sleepiness. Research suggests that people who have problems both falling asleep and staying asleep are at greater risk for depression. In addition, some medications used to treat depression can cause sleep disturbances.
What about sleep apnea?
According to a study from the Centers for Disease Control and Prevention (CDC), Obstructive sleep apnea (OSA) is associated with depression, regardless of weight, age, sex or race. The study analyzed survey data from 9,714 adults in the United States and found that the likelihood of depression increased with the reported frequency of snorting and paused breathing during the night.
Researchers suggest that better screening for OSA and depression could help address these frequently underdiagnosed conditions, especially if sleepiness is a problem.
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Does depression cause fatigue?
A May 2012 study looked at 508 children with ADHD who were also suffering from daytime fatigue. Researchers found that although these kids were getting enough sleep at night, they were still experiencing excessive daytime sleepiness, attention and hyperactivity problems and learning difficulties. Kids without excessive daytime sleepiness did not have attention or learning problems. Researchers then found that obesity, inattention, depression, anxiety, asthma, and parental insomnia all contributed to the children’s daytime fatigue.
Are there new depression treatments that don’t affect sleep?
A new type of depression treatment, called Transcranial Magnetic Stimulation Therapy (TMS), has been found to treat depression without causing sleep or arousal problems, as many anti-depressant medications can. Researchers did a second analysis of a study with 301 patients to see how TMS works on patients who do not respond to traditional anti-depressant treatment.
Patients were given 40-minutes TMS sessions five days a week for six weeks. Researchers verified previously successful reports that these sessions improved depression, but went on to discover that sleep problems were not a side effect. Because sleep and depression are so closely connected, this treatment could be used with patients who are experiencing insomnia due to depression.
The majority of people with major depression suffer from insomnia, and antidepressants either sedate the person, or speed up their system making sleep difficult. TMS is used on the prefrontal cortex, which is responsible for mood regulation, as well as decision-making, evaluation and planning. Researchers say there are remarkably few side effects to the treatment.
n.p. “Depression and Sleep.” National Sleep Foundation. Retrieved from http://www.sleepfoundation.org/article/sleep-topics/depression-and-sleep
American Academy of Sleep Medicine. (2012, April 1). "Survey Finds Association Between Symptoms Of Obstructive Sleep Apnea And Depression." Medical News Today. Retrieved from
American Academy of Sleep Medicine. (2012, May 3). "Obesity, Depression/Anxiety, ADHD, Asthma Contribute To Fatigue Even After A Good Night's Sleep." Medical News Today. Retrieved from
n.p. (2012, October 28). "Magnetic Brain Stimulation Cures Depression Without Affecting Sleep." Medical News Today. Retrieved from http://www.medicalnewstoday.com/articles/252082.php.