Depression, therapy, and sleep

There are both cognitive and physical markers of depression. Luckily, cognitive effects of depression can be treated through therapy. Cognitive-behavioral therapy (CBT) is a highly effective therapy system through which patients are trained to modify their thought processes and associated habits. By changing thought processes, one can eliminate negative or recurring maladaptive ideas, which helps to alleviate depression. Given this, it was hypothesized that CBT, in conjunction with relaxation breathing exercises, might improve physical deficits associated with depression.

Two deficits, poor sleep quality and heartbeat irregularity (instability), were examined. To test this, 43 participants underwent CBT in conjunction with breathing relaxation exercises for 4 weeks. At the beginning and end of treatment, participants had their sleep and heart rate variability measured. The investigators also collected data on participant health (e.g., psychiatric history, age, etc.). Changes in sleep and heart rate variability were compared between the initial session and the follow up (post-therapy) session to assess the effects of therapy and breathing exercises. In addition, these individuals were compared with a control group with participants who did not undergo therapy or breathing relaxation training but who completed all other tasks.

After statistically controlling for many factors that affect both sleep and heart rate variability, it was found that sleep quality and heart rate variability improved in the experimental group following therapy + breathing relaxation. On the other hand, these factors did not improve in the control group.

This study is important, as it shows sleep alterations caused by depression can be alleviated with therapy. If sleep disturbances are not reduced, they can exacerbate poor cognitive health. Therefore, improving sleep is of much importance. 

In individuals with sleep apnea, this study is extra important. Sleep apnea is associated with elevated depression levels, and it is also associated with disrupted sleep. Treating depressive symptoms may be able to help sleep quality, which makes it easier to tolerate CPAP treatment. See your sleep physician if you believe this may be an option for you.


Souce: Chien, H. C., Chung, Y. C., Yeh, M. L., & Lee, J. F. (2015). Breathing exercise combined with cognitive behavioural intervention improves sleep quality and heart rate variability in major depression. Journal of Clinical Nursing [In Press].

Janna Mantua


Janna is a PhD Student / Graduate Research Assistant at University of Massachusetts Amherst with a background in clinical sleep research and psychology. Janna Mantua is a PhD student in the Behavioral Neuroscience department at the University of Massachusetts. Her research focuses on sleep and aging, with specific projects on cognitive health, inflammation, memory formation, and neuroimaging. Prior to her PhD work, Janna was involved in research on sleep apnea and cognitive decline at the NYU Sleep Disorders Center.

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