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Depression & Low Self Esteem, Anxiety & Stress, Relationships & Couples, Addictions, Habits & Eating Disorders, For Therapists

Depression & Insomnia: How CBT for Sleep Boosts Mood, Rest, and Daily Functioning

Judi Markowitz, Psy.D.

Cognitive Behavioral Therapy for Insomnia to Treat Major Depressive Disorder with Comorbid Insomnia: A Systematic Review and Meta-analysis


Journal of Affective Disorders, 2024
Sleep disturbance is an extremely common symptom of Major Depressive Disorder (MDD), with nearly 90% of people with MDD reporting insomnia or other disrupted sleep (Mason et al., 2020). In the largest meta-analysis to date—19 randomized controlled trials encompassing 4,808 adults with both MDD and insomnia—researchers found that a brief course of Cognitive Behavioral Therapy for Insomnia (CBT-I) reliably improves both sleep and depressive symptoms, outperforming control conditions (Furukawa et al., 2024). 
 
CBT-I combines sleep education (e.g., sleep hygiene) with cognitive strategies that challenge negative beliefs about sleep, and behavioral techniques like limiting time in bed and stimulus control to promote a feeling of being tired, improve the quality of sleep, and restore natural sleep rhythms.

 

Highlights from the Study

“...CBT-I is effective for alleviating depressive symptoms among adults with major depressive disorders with moderate certainty of evidence. It also leads to more remission in insomnia symptoms, although it may lead to more dropouts than control conditions.”

 

The study indicated: “...our sensitivity analysis suggested that the improvement in depression was seen beyond the sleep domain.”

 

“...its applicability is not restricted to specialized settings. This means that many clinicians can utilize CBT-I in their daily clinical practices.”
 


At Feeling Good Institute, many therapists integrate CBT-I within the TEAM-CBT framework, equipping clients to restore restful sleep and build durable skills to treat depression, anxiety, relationship issues, and unwanted habits.  

 

Learn about the essential skills for effective cognitive behavior therapy and how we set therapists up for success.

 

Research Brief Author:  Judi Markowitz, Psy.D

 

Furukawa Y, Nagaoka D, Sato S, Toyomoto R, Takashina HN, Kobayashi K, Sakata M, Nakajima S, Ito M, Yamamoto R, Hara S, Sakakibara E, Perlis M, Kasai K. Cognitive behavioral therapy for insomnia to treat major depressive disorder with comorbid insomnia: A systematic review and meta-analysis. J Affect Disord. 2024 Dec 15;367:359-366. doi: 10.1016/j.jad.2024.09.017. Epub 2024 Sep 4. PMID: 39242039.

Additional reference: Mason BL, Davidov A, Minhajuddin A, Trivedi MH. Focusing on insomnia symptoms to better understand depression: A STAR*D report. J Affect Disord. 2020 Jan 1;260:183-186. doi: 10.1016/j.jad.2019.08.094. Epub 2019 Aug 30. PMID: 31499373; PMCID: PMC6803100.
 

 

 

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