Clinical implications of the causal relationship between insomnia and depression: how individually tailored treatment of sleeping difficulties could prevent the onset of depression

摘要

Major depression commonly co-occurs with symptoms of insomnia. However, the underlying psycho-biological mechanisms which can explain this relationship are still not well understood. Hyperarousal and negative emotionality have been proposed to be possible mediating factors. Several studies have suggested that insomnia could be a predictor of depression. A recent meta-analysis conducted by our group showed that people with insomnia have a two-fold risk to develop depression, compared to people with no sleep difficulties. Thus, early diagnosis and treatment of insomnia could, at least partially, prevent the development of future depression, by identifying people at risk for depression and deliver personalized intervention protocols to improve individual outcome. Modifications of existing treatment modules are needed, as adding sleep protocols to the treatment of depression and affective regulation protocols to the treatment of insomnia, enhance the accessibility for the treatment of insomnia, and develop sleep education protocols in early periods of life.