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Chicken or Egg: Insomnia Causes Depression or Vice Versa?

It’s long been thought that depression causes sleep problems, but now researchers believe that poor sleep can cause depression. Thus they are studying the link between insomnia and depression, but insomnia, of course, isn’t the only cause for poor nighttime sleep. Perhaps we should just say that poor sleep can result in depression.

“Clearly, poor sleep can cause depression and depression can cause poor sleep,” observes Dr. Steven Feinsilver, director of the Center for Sleep Medicine at Mount Sinai School of Medicine in New York City.

So we’re now looking at the classic “which came first” question — the chicken or the egg, or depression or poor sleep.

At any rate, the observation that poor sleep can cause depression has led to a whole new approach to treating insomnia. Now when someone is suffering from insomnia, that person may also be treated — through talk therapy — for depression at the same time that the insomnia is being treated.

Evidence does exist that for many people, symptoms of insomnia precede symptoms of depression by a few years, Feinsilver notes. “This could be taken to mean either that insomnia causes depression or that insomnia is the earliest symptom of depression.”

According to the National Library of Medicine, some 20 million Americans suffer from depression, and about half of those also suffer from insomnia.

A Ryerson University (Toronto) study found that 90 percent of patients who were given insomnia therapy and either an antidepressant drug or placebo saw their depression recede after their sleeplessness did. Thus the sleep therapy seemed to be the most responsible for ending the depression.

So far, this research is all preliminary and will require further tests and samples, but as we’ve mentioned here many times, poor sleep is not something to be shrugged off, regardless of the cause. Poor sleep invariably has daytime consequences, whether in mere tiredness or in worse outcomes such as an inability to function or focus fully, and of course depression itself.

If you have sleep issues, you really need to seek professional help, just as you would if you had a chronic disease that left you fatigued, unfocused or depressed in your waking hours.

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