Are You Depressed -- or Just Sleepy?

Sleep loss and depression are so closely linked, treating one condition will often improve the other.

From the WebMD Archives


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 thoughts.

“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 first.”

WebMD Feature Reviewed by Michael W. Smith, MD on January 19, 2010



Mark Mahowald, MD, director, Minnesota Regional Sleep Disorders Center, Minneapolis.

R. Robert Auger, MD, sleep specialist, Mayo Center for Sleep Medicine, Rochester, Minn.

Jason Ong, PhD, director, behavioral sleep medicine program, Rush University Medical Center, Chicago.

Susan Zafarlotfi, PhD, clinical director, Institute for Sleep and Wake Disorders, Hackensack University Medical Center, New Jersey.

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