Sleep problems linked to depression

Everyone feels a little down sometimes and temporary spans of sadness
are common in times of failure or personal loss. Depression, however,
is defined as an ongoing state of low mood and aversion to activity
that can affect a person’s thoughts, behaviours, feelings and physical
well-being.  The Public Health Agency of Canada estimates that 4.8% of
Canadians suffer from major depression.

The relationship between sleep and depression is complex and varies
from person to person. Sleep problems are not only a symptom of
depression but in some cases, they’re also the cause. In some
patients, symptoms of depression appear before the onset of sleep
problems, but others report sleep problems first. Two particular sleep
disorders that are commonly linked with depression are insomnia and
obstructive sleep apnea (OSA.)

Insomnia is very prevalent among those with depression. In fact,
according to the National Sleep Foundation, people with insomnia are
10 times more likely to develop depression compared with people who
sleep well. Symptoms of insomnia related to depression include
difficulty falling asleep (sleep onset insomnia), difficulty staying
asleep (sleep maintenance insomnia), unrefreshing sleep, and daytime
sleepiness.

OSA, a form of sleep-disordered breathing, is also strongly linked to
depression. A Stanford study found that people who suffered from OSA
were also five times more likely to suffer from depression. Since OSA
and depression share several symptoms, OSA is often under-diagnosed
amongst depressed patients. Fortunately, when OSA is discovered and
treated with continuous positive airway pressure (CPAP), research
shows that depressive symptoms are also often alleviated.

While the relationship between sleep disorders and depression is
complex, both can be treated using  a combination of psychotherapy
and/or medication treatments. Cognitive Behavioural Therapy is a
non-drug treatment that is growing in popularity. It involves three
key components: cognitive, behavioural and physiological techniques.
Ultimately, if you suffer from depression or are concerned that your
sleep disorder may lead to depression, speak to your physician about
the many medical treatments and coping strategies available.

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