Are You Depressed -- or Just Sleepy?
Sleep loss and depression are so closely linked, treating one condition will often improve the other.
Seeing a Sleep Specialist
A sleep specialist will conduct a thorough evaluation and sleep study, in
which you are monitored while sleeping, and then develop a treatment plan.
Your better sleep treatment plan may include medication as well as good
sleep hygiene techniques – ways to prepare your body for sleep. Avoiding
caffeine after lunch, not consuming alcohol within six hours of bedtime, and
not smoking or using any type of nicotine product before bedtime are some sleep
hygiene techniques. Experts may also teach you relaxation techniques and
cognitive therapy, in which you learn to replace sleep worries with positive
“We also use a very powerful technology called ‘stimulus control,’” says
Auger. Essentially, stimulus control is a behavioral technique that limits the
time you spend in bed.
"It teaches people to use the bedroom for sleep and sex, and to leave the
bedroom after about 20 minutes if they can’t fall asleep and engage in a
relaxing activity,” he says. “It can be as powerful as medications and possibly
more powerful in the long term.”
Treating Depression to Improve Insomnia
“Insomnia can precede a bout of depression or increase risk of a relapse in
someone with a history of depression, but treating the insomnia can improve the
outcomes of depression,” agrees Jason Ong, PhD, director of the behavioral
sleep medicine program Rush University Medical Center in Chicago.
But Ong says it’s also important to address the depression that may exist
independently of the sleep issues. If you think you are depressed, be sure to
discuss this with your doctor, who can help you decide on whether treatment for
it should be part of your sleep therapy.
Some antidepressants may also cause sleeplessness. In that case, your doctor
or sleep specialist can investigate other options. ”Try to find an
antidepressant with sedating properties,” Ong says. “Or if the most
effective antidepressant for you causes insomnia, you may be able to take it in
the morning instead of night.”
Susan Zafarlotfi, PhD, clinical director of the Institute for Sleep and Wake
Disorders at Hackensack University Medical Center in New Jersey, uses insomnia
as a clue to other issues when evaluating a new patient.
“Insomnia is one of the ways to identify depression, and I make sure all of
my patients get depression and anxiety screening,” Zafarlotfi says. “We need to
address both the sleep problem and the depression. It doesn’t matter which came