Insomnia treatment may prevent major depression in elderly, JAMA study.

The study enrolled 291 adults 60 years or older with insomnia disorder who had no major depression or major health events in past year. Participants were randomized to 2 months of CBT-I (n = 156) or SET (n = 135).

It was found that incident or recurrent major depression occurred in 19 participants (12.2%) in the CBT-I group and in 35 participants (25.9%) in the SET group, with an overall benefit consistent across subgroups. Remission of insomnia disorder continuously sustained before depression event or during follow-up was more likely in CBT-I participants.

Those in the CBT-I group with sustained remission of insomnia disorder had an 82.6% decreased likelihood of depression compared with those in the SET group without sustained remission of insomnia disorder.

Treatment with CBT-I yielded an annual incidence of depression at 4.1%, similar to the population rate and half the rate in SET at 8.6%, consistent with a 2-fold greater risk of depression in those with insomnia.

A novel approach to beat the stigma

"This study indicates that an intervention aimed at insomnia can effectively reduce the incidence of major depression in those without a depressive disorder at the start of the intervention, meaning that depression can be prevented effectively without even using the word depression and thus avoid the associated stigma", note Cuijpers et al in an accompanying editorial.

This major finding offers exciting new opportunities for the prevention field and opens a new field of research into indirect preventive interventions for avoiding the stigma of mental disorders.

Source: JAMA Pschiatry:

1. doi:10.1001/jamapsychiatry.2021.3153

2. doi:10.1001/jamapsychiatry.2021.3422