A treatment for insomnia can help relieve depression during menopause

(Reuters Health) – A recent experiment suggests that menopausal women have fewer symptoms of depression when they get treated for insomnia than when they do not.

The researchers recruited 117 postmenopausal women with insomnia for the study and randomized them into three groups. One group received cognitive behavioral therapy (CBT). Another group received a component of CBT called sleep restriction therapy. The third group received only instruction on sleep hygiene, or on habits that facilitate fall and sleep.

Overall, 4.3% of women had moderately severe depression. Both forms of insomnia treatment have helped relieve the symptoms of depression in these women, in contrast to sleep hygiene education.

"We can add targeted cognitive-behavioral treatment of insomnia to the current arsenal of treatments to relieve insomnia related to menopause. This treatment offers the added benefit of reducing depressive symptoms, which occur frequently with sleep disorders badociated with menopause, "said lead author of the study, Christopher Drake, of the Henry Ford Health System. of Detroit, Michigan

"We hope to show one day that targeting the symptoms of insomnia as soon as depression is mild or developing can prevent depression from developing," Drake said via email.

Women usually undergo menopause between 45 and 55 years old. When the ovaries inhibit the production of estrogen and progesterone hormones, they can present symptoms ranging from badl dryness to mood swings, as well as joint pain and insomnia.

CBT can train people to use techniques that address the mental (or cognitive) factors badociated with insomnia, such as "the spirit that wraps around", and to overcome the "mental illness" that surrounds them. worry and other negative emotions that often accompany the inability to sleep. CBT can also help people with poor sleep establish a healthy bedtime routine and improve sleep habits, previous research has shown.

Sleep restriction therapy can be practiced alone or as a component of CBT in case of insomnia. This intervention aims to limit the number of times people wake up at night and reduce the total time spent in bed; It is not intended to limit the total time that people spend sleeping.

Women in the study who received a CBT attended six face-to-face therapy sessions with a registered nurse specializing in behavioral sleep medicine. Sleep restriction therapy was shorter and consisted of two face-to-face sessions and three telephone sessions.

Meanwhile, the patient control group badigned to sleep hygiene education received six weekly emails with tips on how to create better nightly routines and information on the link between sleep and a variety of health problems and lifestyle habits.

Just after the treatment of insomnia, depressed women who received CBT experienced a moderate to severe reduction in mood disorder symptoms, researchers reported in Sleep Medicine.

Patients also reported a moderate improvement in depression with sleep restriction therapy, but these effects only occurred six months after the end of treatment, the study also revealed.

One of the drawbacks of the study is that it excludes women who have been diagnosed with major depression. Therefore, it is not clear to what extent these insomnia treatments would work for these women, noted the researchers. Differences in the duration and form of treatment between the types of insomnia therapies tested may also have affected the results.

The researchers also did not examine hot flashes – a common symptom of menopause that can prevent women from sleeping well – and it is possible to tackle this aspect of menopause, which could have an impact on mood and sleep, "said Mary Jane Minkin, a researcher at Yale University School of Medicine in New Haven, Connecticut, who did not participate in the event. study.

The study also did not examine the impact of hormone therapy, which doctors could prescribe to relieve various symptoms of menopause, Minkin said via e-mail.

"Hormone therapy usually has a significant impact on sleep," said Minkin.

"It's good to know the benefits of CBTI for insomnia, which is still potentially a valuable addition," said Minkin. "But clinicians should never forget to think about the potential role of hormone therapy."

SOURCE: bit.ly/2CvBwrz Sleep Medicine, online December 28, 2018.