• Published in SilverCloud Health                              

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Sleep disorders are a growing epidemic, with as many as 150 million people affected worldwide. It is estimated that 30% of the population in UK alone are severely sleep deprived and while recommended sleep times for an adult range from 7 to 9 hours, the average British person sleeps about 6.8 hours each night, putting physical and mental health at risk.

This number is likely to increase[1] and since sleep deprivation is commonly associated with accidents and human errors, the consequences of this epidemic have a significant economic and social impact. Considerable evidence[2] shows that leaving the most prevalent sleep disorders untreated has a far higher cost than delivering adequate treatment. Is it estimated that insomnia costs the UK economy up to £40 billion per year in lost productivity – nearly 2% of the country’s GPD.

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Insomnia and depression

While sleep disorders are often cause of low work productivity, increased absence from work, and higher rate of motor vehicle accidents[3], research also show a close bond between sleep disturbances and mental health conditions, particularly between insomnia and depressive and anxiety disorders. It is estimated that 40% of insomnia patients have a psychiatric condition. 

Not only poor sleep may be a symptom of a mental health conditions, but it can also be the cause of it. The relationship is complex and goes both ways. For example, insomnia is very common in people who suffer from depression and people with insomnia have higher risk of developing depression[4].

This relationship can be summarized in three key points:

• • People with psychiatric disorders are more likely to be affected by sleep deprivation;
• • The risk of developing a mental illness is higher in people with sleep difficulties;
• • Treatment of sleep disorders can help prevent and alleviate mental health problems.
  
  

Treating insomnia and depression

Sleep therapies play a key role in the treatment of mental disorders. Treatments for insomnia can be both medical, such as hypnotics, and non-medical, such as Cognitive Behavioural Therapy (CBT). Few studies have compared these two approaches and found that while short-term outcomes may be similar, CBT therapies may be more durable than medications[5]. 

CBT for sleep deprivation can help to alleviate symptoms of mental health disorders. Studies indicate that treating insomnia with CBT can double the success of depression treatments.[6] They also avoid side effect of pharmacotherapy.

Our own in-service research demonstrates that cCBT for sleeping difficulties not only improves the symptoms of insomnia but that 75% of those with mild to moderate depression and anxiety recover and need no further treatment.

CBT therapy delivered online in this way provides a low-cost, scalable intervention that helps remove barriers to access for those people who are more reluctant to accept they have mental health needs or have concerns around stigma. 

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[1] https://academic.oup.com/ije/article/40/6/1431/804651 

[2] https://www.ncbi.nlm.nih.gov/books/NBK19958/ ; https://pubmed.ncbi.nlm.nih.gov/12075483/

[3] https://www.researchgate.net/publication/49841274_The_societal_costs_of_insomnia 

[4] https://www.sleepfoundation.org/baby-sleep/sudden-infant-death-syndrome 

[5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4730295/ 

[6]  https://www.nytimes.com/2013/11/19/health/treating-insomnia-to-heal-depression.html?pagewanted=all