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J Affect Disord. 2014 Oct;168:415-21. doi: 10.1016/j.jad.2014.07.020. Epub 2014 Jul 18.

Insomnia before and after treatment for anxiety and depression.

Author information

1
Clinical Research Unit for Anxiety and Depression (CRUfAD), University of New South Wales at St Vincent׳s Hospital, Level 4, O׳Brien Centre, 394-404 Victoria Street, Darlinghurst, NSW 2010, Australia. Electronic address: emason@unsw.edu.au.
2
Department of Psychology, University of California, Berkeley, 3321 Tolman Hall, Berkeley 94720, USA.

Abstract

BACKGROUND:

Insomnia increases the likelihood of developing a mood or anxiety disorder. Moreover, symptoms of anxiety and depression, such as worry and rumination, contribute to insomnia. Given these relationships, there is a need to delineate how these disorders respond to treatment when they are comorbid.

METHODS:

266 individuals presenting for anxiety and/or depression symptoms participated in this study in which symptoms of insomnia, anxiety, depression, disability, and sleep length were assessed. 102 of these patients were treated with internet-based cognitive behavioral therapy (iCBT) for anxiety and/or depression and 61 completed the treatment. Pre- to post-treatment symptom changes were examined in this subset.

RESULTS:

Insomnia, as measured by the Insomnia Severity Index, was evident in 40% of the patients. Individuals with insomnia reported more severe symptoms of anxiety and depression than individuals without insomnia. iCBT focused on anxiety and/or depression was associated with reductions in symptoms of insomnia, anxiety, depression, and disability. Total sleep time did not change over treatment.

LIMITATIONS:

As the data were collected in routine care, there was no control group and no longer term follow-up assessment.

CONCLUSIONS:

These findings highlight the importance of insomnia across anxiety and depressive disorders. They further demonstrate that treatment for anxiety and/or depression appears to improve comorbid insomnia symptoms, though may be ineffective in changing sleep duration.

KEYWORDS:

Anxiety; CBT; Comorbidity; Depression; Insomnia; Sleep

PMID:
25108278
DOI:
10.1016/j.jad.2014.07.020
[Indexed for MEDLINE]

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