Insomnia treatment may prevent major depression in elderly, JAMA study.
Late-life depression (major depressive disorder in adults >60 years) has a 12-month prevalence that exceeding 10%. Although effective pharmacologic and psychological treatments are available, the effects are modest, relapse rates are high, and many patients do not respond to treatments at all. A recent randomized control trial done by Irwin et al., published in Jama psychiatry has shown that treatment of insomnia may be beneficial in the prevention of depression in older adults.
Older adults with depression often do not receive diagnosis and treatment, and even with treatment, only approximately one-third achieve remission, with an estimated remaining disease burden of 60%. Effective depression prevention is thus the need of the hour.
Pharmacotherapy is often used to treat insomnia, although medication provides only temporary remediation and poses risk for day time effects and dependency. The present study focused on non-pharmacological treatments so as to examine whether treatment of insomnia disorder with cognitive behavioral therapy for insomnia (CBT-I) (combination of cognitive therapy, stimulus control, sleep restriction, sleep hygiene, and relaxation) compared with an active comparator condition, sleep education therapy (SET) (which targets day-to-day behavioural and environmental factors that contribute to poor sleep) prevents major depressive disorder in older adults.
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