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For people living with depression, treating insomnia may improve more than sleep.
A new study from researchers at The University of Western Australia found that people with depression and poor sleep reported improvements in both conditions after a four-week insomnia treatment program.
The changes extended beyond sleep, with participants also reporting less negative thinking, fewer worries about sleep, and greater participation in meaningful activities, including physical and social activities.
The findings suggest that directly addressing insomnia could provide another avenue for improving care for people with depression, particularly when sleep problems persist alongside other symptoms.
“As many as nine in 10 people with depression also have disturbed sleep,” said Vanika Lall, a researcher from UWA’s School of Psychological Science. “Insomnia can make depression worse or last longer and also blunt people’s response to depression treatment. Leaving insomnia untreated increases the risk of depression returning, and while depression treatments can help improve insomnia, they are usually not completely effective.”
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What Happened When Researchers Treated Insomnia
The study, published in Behaviour Research and Therapy, analyzed data from 88 participants in the Sleep Well for Mood study who were experiencing both depression and poor sleep.
Participants received four weeks of cognitive behavioral therapy for insomnia, or CBT-I, and were assessed before treatment, after treatment, and again at a three-month follow-up.
CBT-I is a structured, short-term treatment designed to improve sleep by addressing thoughts and behaviors that contribute to insomnia. It can combine cognitive therapy, behavioral strategies, and sleep education.
Following treatment, participants showed improvements in insomnia symptoms. They also reported less negative thinking about everyday issues, less worry about sleep, and more time spent on meaningful activities.
The changes are notable because negative thinking and inactivity can contribute to depression.
“Negative thinking and an inactive lifestyle fuel depression,” Lall said. “Our results suggest CBT-I is a time- and cost-effective way to treat insomnia and depression together as it improves core drivers of depression within real-world settings.”
Why Sleep Matters in Depression Care
The findings add to the case for paying closer attention to persistent sleep problems in people being treated for depression.
According to the researchers, depression treatment can improve insomnia, but may not completely resolve it. Leaving insomnia untreated can also increase the risk of depression returning.
For nurses caring for patients with depression, sleep problems can therefore be an important part of the clinical picture. Asking about insomnia, sleep-related worries, and changes in daily activity may provide additional insight into a patient’s symptoms and recovery.
The study does not establish that treating insomnia should replace treatment for depression. Instead, the findings suggest that targeting sleep may influence several factors associated with depression and could complement broader mental health care.
Researchers said greater use of CBT-I could help more people achieve longer-term recovery while reducing the healthcare burden associated with recurring depression.
