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Depression and Sleep Medication: Alternatives and Complementary Therapies



Sleeping too much (hypersomnia) or not sleeping at all (insomnia) can be a sign of depression. These sleep problems alone are not the same thing as depression, but they can be one of its important symptoms.


Depression is a mood disorder that is characterized by sadness or feeling blue along with a series of physical symptoms such as low energy, disrupted sleep, and appetite changes. Nearly everyone feels normal sadness or feels down from time to time. Sometimes, however, the sad feelings become intense, last for long periods of time, and involve other physical symptoms that prevent a person from leading a normal life. These feelings often lead to a medical diagnosis of clinical depression.




depression and sleep medication



Treatment choices for depression depend on how serious the illness is. The most effective treatment for depression for most people is often a combination of psychotherapy (counseling or talk therapy) and medication.


Medication tends to work more quickly to ease symptoms while psychotherapy helps people learn strategies to prevent the onset of future symptoms of depression. Psychotherapy can also address coping skills to improve a person's ability to fall asleep.


Doctors may sometimes treat depression and insomnia by prescribing an SSRI (selective serotonin reuptake inhibitor) or other antidepressant along with a sedating antidepressant or with a hypnotic medication. These medicines help you sleep.


SSRIs. These medications can perform double duty by helping you sleep and improving your mood. But for some people, SSRIs can cause insomnia, so your doctor may have you take these in the morning, sometimes with an additional medicine for a short time to help people sleep at night.


SNRIs (serotonin and norepinephrine reuptake inhibitors). These medicines affect two brain chemicals thought to be involved in depression: serotonin and norepinephrine. You might be prescribed these when an SSRI didn't work. You might also get these when your depression comes with other problems such as pain disorders or certain forms of anxiety.


The over-the-counter hormone melatonin also is sometimes used to treat insomnia or sleep disrupted by depression. A prescription drug called ramelteon (Rozerem) works in a way similar to melatonin and is also used to treat insomnia.


In some cases, doctors will prescribe drugs for the treatment of insomnia. All insomnia medications should be taken shortly before bed. Do not attempt to drive or perform other activities that require concentration after taking an insomnia drug because it will make you sleepy and can increase your risk for accidents. Medications should be used in combination with good sleep practices.


The FDA issued warnings for prescription sleep drugs, alerting patients that they can cause rare allergic reactions and complex sleep-related behaviors, including "sleep driving." They also warned people that taking sleeping medication at night can impair their ability to drive or be fully alert -- even the next day.


Sleep problems can exacerbate depression, leading to a negative cycle between depression and sleep that can be challenging to break. Poor sleep may even provoke depression in some people. Understanding the complex relationship between sleep and depression can be an important step in improving sleep quality and better managing depression.


Depression and sleep are closely connected. A majority of people with depression experience sleep issues. In fact, doctors may hesitate to diagnose depression in the absence of complaints about sleep Trusted Source Elsevier Elsevier is a publishing company that aims to help researchers and health care professionals advance science and improve health outcomes for the benefit of society. See Full Reference .


Depression and sleep issues have a bidirectional relationship Trusted Source National Center for Biotechnology Information The National Center for Biotechnology Information advances science and health by providing access to biomedical and genomic information. See Full Reference . This means that poor sleep can contribute to the development of depression and having depression makes a person more likely to experience sleep troubles. This complex relationship can make it challenging to know which came first, sleep issues or depression.


Approximately 40% of people with insomnia have clinical depression, and up to 80% of patients with depression experience bouts of insomnia Trusted Source UpToDate More than 2 million healthcare providers around the world choose UpToDate to help make appropriate care decisions and drive better health outcomes. UpToDate delivers evidence-based clinical decision support that is clear, actionable, and rich with real-world insights. See Full Reference . Early wakening is closely associated with depression, as well as difficulty falling asleep at night. Those with depression may switch back and forth between insomnia and hypersomnia during a single period of depression.


In addition to troubling moods and thoughts, depression can also manifest in physical changes that interfere with daily activities. Symptoms may include Trusted Source Anxiety and Depression Association of America (ADAA) ADAA's mission focuses on improving quality of life for those with anxiety, depression, OCD, PTSD, and co-occurring disorders through education, practice, and research. See Full Reference :


Depression is more common in women, and there may be differences in the symptoms of depression based on sex and age. Men often experience symptoms such as anger, whereas women more frequently experience sadness and guilt. Adolescents with depression may be irritable and have trouble in school, and younger children may pretend to be sick or worry that a parent may die.


If your sleep quality or general quality of life is routinely affected by troubling feelings or low mood, it is important to share these concerns with a health care provider. Typically, symptoms must remain present for at least two weeks to be formally diagnosed as clinical depression. A medical professional can determine whether your symptoms are caused by depression or another health condition.


Fortunately, people who undergo treatment for major depression often report improved sleep quality. After working with a doctor or mental health provider to understand the type and severity of depression, a treatment plan will be created accordingly.


Sleep problems can increase the risk of initially developing depression, and persistent sleep issues can also increase the risk of relapse in people who have successfully been treated for depression. As a result, implementing these healthy habits can both help you sleep better, boost your mood, and help decrease some of the challenging symptoms of depression.


There are several different kinds of therapy to help you cope with depression and change your thought patterns around sleep. Therapeutic models such as CBT, interpersonal psychotherapy, and psychodynamic therapy can help you process some of the underlying feelings and challenges that contribute to depression. Mental health professionals can also suggest concrete behavioral changes to mitigate some of the symptoms of depression and provide coping mechanisms to manage restless, sleepless nights.


Suffering from depression can make it difficult to stick to a routine. Waking up and going to sleep at the same time each day gives your body an opportunity to get the requisite seven to nine hours of sleep per night. Additionally, establishing a nightly routine provides a cue for the body to wind down and prime itself for sleep.


It can be tempting to have a drink or two to promote relaxation and sleepiness, but alcohol has a harmful effect on sleep. While studies have shown that binge-drinking before bed leads to difficulty falling asleep and staying asleep, even moderate drinking is enough to disrupt the sleep cycle and shorten REM sleep.


Research indicates those who engage in light, moderate, or vigorous exercise reported very good or fairly good sleep quality. Additionally, regular exercise has shown to significantly decrease symptoms of depression, making it an excellent choice to promote sleep health and mental health. If you decide to implement an exercise regimen, consider doing your workout during the first half of the day, as exercising in the evening could interfere with your ability to fall asleep.


Treatments such as cognitive behavioral therapy for insomnia and continuous positive airway pressure (CPAP) devices for apnea can restore good sleep, helping you sidestep related conditions like depression. (People with sleep apnea have a fivefold higher risk of depression.)


These include feeling hopeless, helpless or sad; trouble concentrating and remembering things; loss of energy; daytime sleepiness; loss of interest in activities that once gave you pleasure; or thoughts of suicide or death. Tell your doctor if you have any of these. (Call 911 if you have thoughts of suicide.)


Depression is a common occurrence in a chronic pain condition, and insomnia is quite common in depression. If the individual with chronic pain is also experiencing clinical depression, treating the depression with psychological treatment and an appropriate antidepressants (antidepressant medication), if indicated, may also help with the sleep disruption as well as other symptoms of depression.


Even in chronic back pain patients who are not experiencing significant or clinical depression, sedating antidepressants are often used in low doses to help with insomnia as well as providing some analgesic (pain relieving) benefit.


It should be noted that when these medications are used for sleeping and pain relieving properties, it is in much lower doses than when used in the treatment of depression. Benefits of these antidepressants include:


Cet article se penche sur les relations entre le sommeil et la depression. La plupart des troubles dépressifs se caracterisent par des troubles subjectifs du sommeil, la régulation du sommeil étant étroitement liée aux mécanismes impliqués dans la physiopathologie de la dépression. Après un court rappel de la physiologie et de la topographie du sommeil normal, les troubles mis en évidence dans les études sur le sommeil au cours de la dépression grâce à des enregistrements polysomnographiques et à des évaluations de neuro-imagerie sont étudiés. Puis les implications thérapeutiques des troubles aux niveaux cliniques et neurobiologiques sont examinées. La plupart des antidépresseurs suppriment les mouvements oculaires rapides (MOR), bien que cet effet ne soit ni nécessaire ni suffisant pour une efficacité clinique. Les effets sur les difficultés du patient à s'endormir ou à prolonger son sommeil sont plus spécifiques de certains types d'antidépresseurs. Idéalement, un antidépresseur efficace permettra de normaliser les troubles du sommeil tout en traitant le syndrome depressif, bien que, en réalité, il existe très peu de mécanismes restaurant le sommeil à onde lente diminué. Les antidépresseurs qui bloquent I'histamine 1 et la serotonine 2 centrales ont un effet plus important sur le maintien du sommeil, mais sont aussi connus pour induire une sédation diurne. Un traitement supplémentaire avec des hypnotiques sédatifs - efficaces d'emblée, des benzodiazépines de plus courte durée d'action et des composés sélectifs de l'acide γ aminobutyrique (GABA A) comme le zolpidem- est souvent utilisé pour traiter l'insomnie associée plus rapidement. Un traitement cognitivocomportemental et d'autres stratégies non pharmacologiques sont également utilisés. 2ff7e9595c


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