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Sleep Disorders: Sleep Problems Linked to Depression

What Is Depression?

Depression is a mood disorder that is characterized by sadness or feeling blue. Nearly everyone feels sad or down from time to time. Sometimes, however, the sad feelings become intense, last for long periods of time, and prevent a person from leading a normal life.

How Are Sleep and Depression Linked?

An inability to sleep, or insomnia, is one of the signs of depression. Lack of sleep alone cannot cause depression, but it does play a role. Lack of sleep caused by another medical illness or by personal problems can make depression worse. An inability to sleep that lasts over a long period of time is also an important clue that someone may be depressed.

What Treatments Are Available for Depression-Related Insomnia?

Usually, once the depression has been successfully treated, symptoms of insomnia will improve.

Treatment choices for depression depend on how serious the illness is. The most effective treatment for depression for most people is a combination of psychotherapy (counseling or talk therapy) and medication. Medication tends to work more quickly to decrease symptoms while psychotherapy helps people learn coping strategies to prevent the onset of future depressive symptoms. Psychotherapy can also address coping skills to improve a person's ability to fall asleep.

Medications

Doctors may sometimes treat depression and insomnia by prescribing an SSRI (selective serotonin reuptake inhibitor) or other antidepressant along with a sedating antidepressant or with a hypnotic medication (medication that helps people sleep).

Antidepressants include:

  • SSRIs like Zoloft, Prozac, Celexa and Paxil. These medications can perform double duty for patients by helping them sleep and elevating their mood, though some people taking these drugs may have trouble sleeping.
  • SNRIs (serotonin and norepinephrine reuptake inhibitors) like Effexor, Pristiq, Khedezla, Fetzima, and Cymbalta. These medicines affect two neurotransmitters (brain chemicals) thought to be involved in depression -- serotonin and norepinephrine -- and are sometimes favored when an SSRI is not effective, or when depression occurs with other problems such as pain disorders or certain forms of anxiety.
  • Tricyclic antidepressants such as Pamelor and Elavil
  • Sedating antidepressants such as Trazodone, Remeron, and Silenor

Hypnotics include:

  • Ambien/Ambien CR
  • Sonata
  • Lunesta
  • Restoril
  • Serax

 

What Other Techniques Can Help With Sleep?

In addition to trying medications, here are some tips to improve sleep:

  • Learn and practice relaxation and deep breathing techniques.
  • Clear your head of concerns by writing a list of activities that need to be completed the next day and tell yourself you will think about it tomorrow.
  • Get regular exercise, no later than a few hours before bedtime.
  • Don't use caffeine, alcohol, or nicotine in the evening.
  • Don't lie in bed tossing and turning. When you can't sleep, go into another room and do something relaxing. When you start feeling like you may be able to sleep, get back in bed.
  • Use the bed only for sleeping and sexual activity. Don't lie in bed to watch TV or read. This way, your bed becomes a cue for sleeping, not for lying awake.

 

WebMD Medical Reference

Reviewed by Joseph Goldberg, MD on May 17, 2012

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