What Is Sleep Therapy?
Sleep Therapy is this idea that, if one gets a good night’s sleep, the body will respond in kind with repairing and restoring cellular functions and guiding the system toward health. As disturbed sleep is one of the core imbalances found with major depressive disorder, bipolar disorder, and other diagnosed psychiatric conditions, some postulate that treating underlying sleep disturbances will have corresponding benefits for mood.
CBT-I: A Drug-Free Alternative
Sleep Therapy is a refreshing direction for treating depression because it does not rely (specifically) on the use of medications. While medication may be prescribed along with sleep therapy, the therapy, itself, doesn’t involve pharmaceuticals of any kind. Instead, like other cognitive behavioral therapies, the entire idea is for the patient to shift perspectives by shifting thoughts and behavior patterns. The treatment is called Cognitive Behavioral Therapy for insomnia, or CBT-I for short.
Sleep therapy takes the paradigm of depression causing sleep disturbances and reverses it, positing that perhaps the sleep disturbances may be causing or worsening the depression. This new perspective looks at some of these behaviors as root causes of depression and sleep disturbances rather than symptoms. These behaviors may include:
- Not waking up at the same time on a consistent basis
- The mental association that sleep takes effort
- Associating being in bed with unhealthy behaviors such as:
- Eating in bed
- Reading in bed
- Watching television in bed
- Attempting to fall asleep with the television on
- Daytime napping
The Body’s Natural Circadian Cycle
The body’s natural circadian cycle is thought to encompass a series of biological cycles that gets reset every 24 hours. Watching other primate behaviors, it’s instinctive for humans to sleep at night and be awake during the day. While many species are nocturnal, just about every living thing has a cycle that closely follows night and day variations. Many people, if left in a “camping” environment with no scheduled structure and no electronic distractions will restore to regular nighttime sleep patterns after several days.
When the body’s natural circadian cycle is disrupted, it can result in insomnia, which is very closely related to depression. Depression may beget insomnia and/or insomnia may precede depression. In other words, depression may be the symptom of insomnia or vice/versa. If we were to focus on insomnia as a root cause, the depression cure rate may go up.
Insomnia & Depression: the Bidirectional Relationship
The link between insomnia and depression is clearly established. However, it is this new way of thinking that suggests that the two have a bidirectional relationship rather than a unilateral relationship.
Traditional Thinking: Unilateral Relationship
As stated before, the traditional way of thinking is believed to be a unilateral relationship. In other words, insomnia never got the attention it deserved because was placed on a “side effect” list. Sleep Therapy places it on the “root cause” list.
Insomnia May Not Be a Side Effect
As a side effect, it is always been thought that if we focus on depression, the insomnia would take care of itself. Because insomnia is so tightly linked and interwoven with depression, it is not surprising that many go to pharmaceuticals as first-line options to help with sleep. The idea behind sleep therapy is that if we change our behavioral patterns, we may not need sleeping aids at all.
The Ideas Behind Sleep Therapy
By changing our behavioral patterns, a person can put his or her circadian rhythms back in sync. Because of the magnetic and innate quality of the circadian rhythm, we can hypothesize that by changing our behavior to match a 24-hour clock, one can work toward patterns of good, restful, and deep sleep. The short-term goal of sleep therapy is to put the body back on a 24-hour cycle. The long-term objective is to cure insomnia as an aid to mitigating depression, again, thinking that the insomnia may be worsening the depression.
Back to Our Roots: an Explanation
CBT-I encompasses training and practicing a set of behaviors and perspectives that the therapist attempts to change in the patient that, as a result, will enable the patient to get a good night’s sleep. Success may be measured by improved sleep quality or duration. Training the circadian rhythm back in sync interrupts the relationship between depression and insomnia.
Sleep Therapy Guidance
In each of the studies, the therapist interviews the patient and attempts to direct and guide his or her behavior to develop healthy habits. CBT-I guides patients along the following guidelines:
- wake up and go to sleep at the same time every day
- only sleep during this period – no daytime napping
- fill your day with activities so you can avoid your bed during the day
- only use your bed for sleeping or intimacy – not eating, reading or watching television
Additional Considerations
Sleep is everything but simple, and patients may have hormonal, breathing, other sleep disorders, or medication interactions that interfere with successful sleep. As with all our recommendations, best to discuss trouble with sleep or depression with a trusted medical professional.
Resources
[1] Sleep Therapy Seen as an Aid for Depression | The New York Times Company
[2] Will Sleep Therapy Transform Treatment for Depression? | TheHuffingtonPost.com, Inc.
http://www.huffingtonpost.com/dr-michael-j-breus/sleep-tips_b_4317493.html
[3] Circadian Rhythms Fact Sheet | U.S. Department of Health and Human Services via National Institutes of Health
http://www.nigms.nih.gov/Education/Pages/Factsheet_CircadianRhythms.aspx
[4] Mayo Clinic: Insomnia Treatment
https://www.mayoclinic.org/diseases-conditions/insomnia/in-depth/insomnia-treatment/art-20046677
