For many years, doctors have typically been taught that insomnia—trouble falling asleep, staying asleep or waking too early—is a symptom of some other underlying issue. For example, if someone has depression and also suffers from insomnia, their doctor usually focuses treatment upon the depression with the hope that as the depression improves, so too will the sleep problem.
The reality, though, is that this is a very antiquated way of thinking about insomnia. Instead, it is really a separate, aka “comorbid,” disorder that requires its own treatment.In most cases, insomnia is not simply a problem of another disorder. We have been treating only a piece of the puzzle, and giving attention to nighttime factors that can influence our health and mood during the daytime is paramount.So why is insomnia so important to take care of from a psychological perspective? Although it is possible that the insomnia may have been caused by a medical or psychiatric condition, particularly in patients with anxiety, it is equally as possible that a sleep disturbance can lead to depression or anxiety.
Nearly 40 percent of patients with depression have noted that their sleep disturbances took hold before their first depressive episode. In 20 percent of patients with depression and insomnia, the sleep disturbance occurred at the same time as the depression. Research with adolescents has suggested that patients with pre-existing insomnia are at a greater risk of developing a future depressive disorder. In addition, insomnia has been reported as an early symptom in first manic episodes.
Based on these findings, it has been suggested that insomnia may actually be an early symptom of numerous anxiety and depressive disorders. Research aimed directly at treating insomnia using Cognitive Behavior Therapy for Insomnia in depressed patients has shown that depression severity can lessen even without directly treating the depression. Even better, targeting both depression and insomnia separately but as part of a comprehensive treatment overall can lead to even more robust results.
The faster that we recognize the connection between sleep and other medical and psychiatric illnesses, the faster we can make sure that those who need treatment for insomnia can get it. We spend nearly a third of our lives asleep, but don’t give it enough credit when thinking about how sleep influences other aspects of our lives. It is finally time that we make sleep a priority.
