Cognitive Behavioural Therapy for Insomnia (CBT-I) to treat depression: A systematic review

Cunningham, Jasmyn E.A.; Shapiro, Colin M.

doi:10.1016/j.jpsychores.2017.12.012

Cited by 199 publications

(111 citation statements)

References 41 publications

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“…One possible source of heterogeneity in the effect of sleep interventions on depression is variation in the size of effect on the sleep symptoms directly targeted. The authors of a recent review of CBT-I in adults with co-morbid major depressive disorder [39] suggest that improvement in depression following CBT-I may be mediated by improvement in insomnia symptoms. There are plausible mechanisms through which improvements in sleep might lead to improvements in depression symptoms.…”

Section: Introductionmentioning

confidence: 99%

The effect of non-pharmacological sleep interventions on depression symptoms: A meta-analysis of randomised controlled trials

Gee

Orchard

Clarke

et al. 2019

Sleep Medicine Reviews

141

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Poor sleep is a significant risk factor for depression across the lifespan and sleep problems have been hypothesised to contribute to the onset and maintenance of depression symptoms. However, sleep problems are usually not a direct target of interventions for depression. A range of non-pharmacological treatments can reduce sleep problems but it is unclear whether these interventions also reduce other depression symptoms. The aim of this review was to examine whether non-pharmacological interventions for sleep problems are effective in reducing symptoms of depression. We carried out a systematic search for randomised controlled trials of non-pharmacological sleep interventions that measured depression symptoms as an outcome. Forty-nine trials (n=5908) were included in a random effects metaanalysis. The pooled standardised mean difference for depression symptoms after treatment for sleep problems was-0.45 (95% CI:-0.55,-0.36). The size of the effect on depression symptoms was moderated by the size of the effect on subjective sleep quality. In studies of participants with mental health problems, sleep interventions had a large effect on depression symptoms (d=-0.81, 95% CI:-1.13,-0.49). The findings indicate that non-pharmacological sleep interventions are effective in reducing the severity of depression, particularly in clinical populations. This suggests that non-pharmacological sleep interventions could be offered as a treatment for depression, potentially improving access to treatment.

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Section: Introductionmentioning

confidence: 99%

The effect of non-pharmacological sleep interventions on depression symptoms: A meta-analysis of randomised controlled trials

Gee

Orchard

Clarke

et al. 2019

Sleep Medicine Reviews

141

View full text Add to dashboard Cite

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“…Strategies that include sleep hygiene education, timed bright light exposure, and napping are recommended (Barion & Zee, ; Richter, Acker, Adam, & Niklewski, ). Cognitive‐behavioural intervention programs that specifically target sleep behaviour also show promise in improving overall mental health outcomes (Cunningham & Shapiro, ).…”

Section: Discussionmentioning

confidence: 99%

Sleep and psychological wellbeing of racehorse industry workers: A survey of Australian trainers

Bullock

Critchley

Davis

et al. 2019

Australian Journal of Psychology

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Background and Objectives This study investigated psychological wellbeing and sleep characteristics in Victorian racing industry workers, specifically focusing on trainers. There are few empirical studies of psychological wellbeing in the horse racing industry, despite considerable employment numbers and a potentially complex and challenging work environment. Early morning starts, and potentially long working days could compound negative wellbeing outcomes. Methods A survey assessing psychological wellbeing and sleep habits was distributed to racing industry employees (N = 358). Results Trainers reported significantly higher depression and anxiety scores compared with other racing industry workers, racehorse owners, and the general population. They had less sleeping hours and higher daytime dysfunction due to fatigue. Multivariate pathway analysis showed daytime dysfunction due to fatigue was the sole significant contributor to identified differences in depression and anxiety between trainers and racing industry counterparts. Conclusions Daytime dysfunction due to fatigue was an important predictor of lower psychological wellbeing in this sample of horse trainers. Longitudinal and qualitative investigation of both sleep and non‐sleep as factors in generating fatigue could assist to further delineate predictors of depression and anxiety in this population. Better understanding of interacting sleep and wellbeing processes may lead to useful self‐management strategies to address the apparent heightened psychological distress of some racing industry workers.

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“…Psycho-educational sleep intervention could include, for instance, stimulus control (e.g., to use their bed only for sleeping, to go to bed only when they were sleepy); sleep restriction (e.g., reducing time in bed with the aim of enhancing homoeostatic sleep pressure); cognitive therapies (e.g. regarding dysfunctional attitudes and beliefs towards sleep); and sleep hygiene and relaxation training [35,37].…”

Section: ) Sleep Education For the Mothermentioning

confidence: 99%

“…Maternal mood might also be protected by sleep interventions. CBT-I has been shown to be effective for reducing depressive symptoms not only among people with insomnia in general [35][36][37][38][39], but also among postpartum women with insomnia [40], although research on cognitive-behavioral sleep interventions is still in its infancy. One RCT designed study of postnatal education focusing on maternal and infant sleep showed signi cant effectiveness for the reduction of risk of high depression scores (adjusted odds ratio = 0.57, 95% con dence interval; 0.34 to 0.94) [32].…”

Section: Introductionmentioning

confidence: 99%

Psycho-educational interventions focused on maternal or infant sleep for pregnant women to prevent the onset of antenatal and postnatal depression: a systematic review

Sasaki

Yasuma

Obikane

et al. 2020

Preprint

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Abstract Background This systematic review aimed to evaluate randomized controlled trials (RCTs) to examine the effect of maternal and infant sleep intervention during women’s pregnancy for the purpose of preventing perinatal depression. Method A systematic search (from inception – January 28 th , 2019) for RCTs using five electronic databases—the Cochrane Controlled Register of Trials (CENTRAL), Embase, PubMed, PsycINFO and Ichushi Web (Japan Medical Abstracts Society)—was conducted. Twelve investigators independently conducted initial screenings based on title and abstract, and then two researchers performed full-text reviews one by one. A meta-analysis would be conducted if at least three studies were found. However, only two articles that met inclusion criteria, and narrative data synthesis was conducted for these two articles. The study protocol has been registered at PROSPERO (CRD42019119999). Result A total of 13,644 studies were initially searched. After removing duplicates, 10,537 studies were screened, and finally, two studies met the inclusion criteria. In both studies, the intervention was a one-time face-to-face session during pregnancy to deliver the behavioral knowledge and skills for optimizing sleep hygiene for both infant and mother. Effectiveness of the intervention in improving maternal mood was not significant in one study. In the other, there was a significant difference in maternal mood between the intervention and control group. No mood comparison was made between baseline and post-intervention. Conclusion This study found limited evidence to support the effectiveness of sleep intervention for all pregnant women, which means “universal intervention”, to protect maternal mental health. Further well-designed RCTs are needed to confirm these findings.

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Cognitive Behavioural Therapy for Insomnia (CBT-I) to treat depression: A systematic review

Cited by 199 publications

References 41 publications

The effect of non-pharmacological sleep interventions on depression symptoms: A meta-analysis of randomised controlled trials

The effect of non-pharmacological sleep interventions on depression symptoms: A meta-analysis of randomised controlled trials

Sleep and psychological wellbeing of racehorse industry workers: A survey of Australian trainers

Psycho-educational interventions focused on maternal or infant sleep for pregnant women to prevent the onset of antenatal and postnatal depression: a systematic review

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