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"Sleep well and live better: overcoming insomnia using CBT" - the links between sleep disturbance and depression (2nd post)

I wrote a first post last month about a workshop I went to given by Professor Colin Espie - "Sleep well and live better: overcoming insomnia using CBT".  I mentioned that he went through the sequence: What is insomnia?  Why is it a big deal?  Why is cognitive behaviour therapy relevant?  Is it clinically effective?  How can it be delivered in real world practice?  In today's post I would like to look more at Why is it a big deal?  And I would like particularly to focus on links between insomnia and depression. 

"Sleep well and live better: overcoming insomnia using CBT"- a workshop with Colin Espie (first post)

Yesterday I went to a one-day workshop with Professor Colin Espie on sleep disorders and CBT organized by the Scottish Branch of the BABCP.  Bike to the station, then a train from Edinburgh to Dundee.  Lovely, early morning light up the Fife coast.  Then a taxi to the conference venue where they were serving egg rolls, bacon rolls, and plenty of coffee for the gradually arriving delegates.

E: Life skills for stress, health & wellbeing, session 5

Modo liceat vivere, est spes.   While there's life, there's hope.

- Terence

Yesterday evening was the fifth session of this 12 evening training course.  I wrote about the fourth session last week.  As usual, this evening, the material we were due to cover was described in a dozen Powerpoint slides which the participants received as a handout.  See slides 1-6, Powerpoint or slides 1-6, PDF and slides 7-12, Powerpoint or slides 7-12, PDF.

Life skills for stress, health & wellbeing, fifth session

Yesterday evening was the fifth session of this 12 evening training course.  I wrote about the fourth session last week.  As usual, this evening, the material we were due to cover was described in a dozen Powerpoint slides which the participants received as a handout.  See slides 1-6, Powerpoint or slides 1-6, PDF and slides 7-12, Powerpoint or slides 7-12, PDF.

Handouts & questionnaires for outcome tracking: depression, mania, side-effects, anxiety, worry, alcohol, sleep, gambling & more

Well, well, well ... what a lot of amazing information there is out there on the internet.  I was trawling to try to find the copyright position of the Panic Disorder Severity Scale (more on this soon in a future post) when I tumbled into Mark Zimmerman's "Outcome Tracker" website.  Mark is "Associate Professor of Psychiatry and Human Behavior at Brown University, the Director of Outpatient Psychiatry at Rhode Island Hospital, and Principal Investigator of the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project."

Recent research: two papers on mindfulness, two on insomnia & two on antidepressants in pregnancy

Here are six recently published research papers.  Barnhofer and colleagues report on encouraging results using mindfulness-based cognitive therapy (MBCT) for sufferers from chronic-recurrent depression while they are still depressed.  The three major studies published already have used MBCT for recurrent depression while the sufferers are reasonably well.  The next step will clearly be a fuller randomized controlled trial.  Heeren and colleagues report on the how MBCT acts to reduce overgeneral autobiographical memoriy in formerly depressed patients. 

Archer and colleagues describe the successful development and assessment of a group-based cognitive behavioural intervention for sleep problems.  Participants' satisfaction ratings with the training were very high and there were very encouraging reductions in their sleep problems and depressive symptoms.  Morin and coworkers also report on CBT for sleep problems, this time singly or combined with sleep medication.  They concluded that "In patients with persistent insomnia, the addition of medication to CBT produced added benefits during acute therapy, but long-term outcome was optimized when medication is discontinued during maintenance CBT."

Recent research: six papers relevant to psychotherapy

Here are six studies relevant to improving psychotherapy outcomes.  Brewin et al report on using imagery-based interventions to help people with depressioin.  Lydiard et al highlight the importance of sleep-related disturbances as a treatment target in PTSD.  McCrady and colleagues show that working with couples rather than just individuals seems more effective when using behavioural therapy to help women with alcohol use disorders.  Geerts et al describe rather amazing research investigating "The role of parental bonding and nonverbal communication in the short-term treatment response was investigated in 104 depressed outpatients. At baseline patients completed the Parental Bonding Instrument. We registered the nonverbal involvement behaviour of patients and interviewers from video recordings of baseline clinical interviews and calculated the convergence between patient-interviewer behaviour over the interview ... As hypothesized, low maternal care and high paternal overprotection predicted a poor response to an 8-week treatment.  Maternal care was positively correlated with nonverbal convergence. Moreover, convergence moderated the relationship between maternal care and the response to treatment: Lack of convergence between patients and interviewers turned out to annul the positive effects of maternal care on the treatment response.

Recent research: lifestyle - five papers on sleep, exercise & stress management

Here are five papers on lifestyle and the benefits of making healthy choices.  The first by Cohen et al on sleep habits and susceptibility to the common cold, showed increased risk of developing a cold after infection for those with shorter sleep duration.  Interestingly the increased risk was even greater for those with poor sleep efficiency.  Sleep efficiency is calculated by dividing the time spent asleep by the time spent in bed trying to sleep.  The Good Knowledge section of this website contains useful information on assessing and treating sleep difficulties.

Recent research: two papers on mindfulness & four on sleep

Here are two papers on mindfulness and four on sleep.  The Kuyken et al paper is important.  It compares mindfulness-based cognitive therapy (MBCT) with continuation antidepressants in the prevention of relapse in recurrent depression.  The results are great - "Relapse/recurrence rates over 15-month follow-ups in MBCT were 47%, compared with 60% in the m-ADM (maintenance antidepressant) group (hazard ratio = 0.63; 95% confidence interval: 0.39 to 1.04).  MBCT was more effective than m-ADM in reducing residual depressive symptoms and psychiatric comorbidity and in improving quality of life in the physical and psychological domains."  I have been cautious in my enthusiasm for MBCT (see previous post) but this is exactly the kind of research that we need to help clarify MBCT's potential further.  The second paper on mindfulness is lower key.  It is a mention of its potential in enhancing sexuality.  It makes sense - see last month's posts on the effects of meditation training on experiencing positive emotions - but the relevant research is still in its early stages. 

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