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What You Need to Know about Depression and Insomnia or Hypersomnia (Oversleeping)
Emily Mendez, MS, EdS
2020-10-12T21:58:40Z
Medically reviewed on by
Dr. Geoffrey Grammer
Chief Medical Officer
When sleep is off-balance, the rest of life can feel like a hazy dream. Sleep problems are a common symptom of depression. One of the functions of sleep is to maintain emotional regulation. When your sleep is disrupted, it can make depression even worse. Fortunately, there are steps you can take to overcome the cycle of depression and insomnia. Here's a closer look at the link between depression and poor sleep, as well as some ways to treat depression for more restful sleep.
The Relationship between Sleep and Depression
Studies estimate that between 65 and 90 percent of adults with MDD experience sleep difficulties. The key link between sleep and depression is in the way that sleep habits affect serotonin levels in the brain. It is believed that sleep irregularities may create a vulnerability to depression because of the stress that disrupted circadian rhythms put on the body. People who sleep too much or too little in response to depression symptoms often experience a cyclical effect where initial poor sleep feeds those symptoms.
Depression and Insomnia
Insomnia is a condition characterized by difficulty falling asleep, difficulty staying asleep, or decreased total sleep time.
For
roughly 75 percent of people with depression, insomnia is a familiar and unwelcome occurrence. Insomnia is not only a symptom of depression, but it is now also recognized as a possible precursor to and exacerbating factor for depression.
A more complete picture of the relationship between depression and insomnia is still emerging. Research suggests that circadian dysfunction is linked to mood changes that may overlap with depression symptoms, but it can be hard to determine whether certain symptoms are the result of depression, insomnia, or both.
Depression and Hypersomnia (Oversleeping)
Oversleeping is a symptom in roughly 15 percent of people with depression. For someone experiencing depression, for example, oversleeping might take the form of regularly sleeping into the afternoon or returning to bed shortly after waking up. Hypersomnia, as it's also known, is characterized by excessive time spent sleeping and/or frequent daytime sleepiness. A person with hypersomnia may experience difficulty waking, staying awake, remaining energized, or thinking clearly during the day. Quality of life can be negatively impacted if someone has a sense of sleepiness thoughout the day since this will distract from being mentally present in a given situation.
What Habits Can Improve Sleep?
It's been established that good sleep hygiene and bedtime habits can improve sleep quality. Cognitive Behavioral Therapy for Insomnia , referred to as CBT-i, is a good first line therapy for insomnia. For some people, however, habits that are generally effective, such as going to bed at the same time each night and eliminating naps during the day, aren't enough to regulate sleep. If you've tried those methods and are still feeling exhausted due to sleep issues, here are some lesser-known steps that may help:
- Light therapy: this form of treatment uses a special box that mimics outdoor light, which can be particularly helpful for seasonal affective disorder (SAD), a condition that's tied to changes in the seasons. Natural light can help improve mood and alertness as well as boost your ability to sleep at night.
- Sleeping with a weighted blanket: New research has found that a weighted blanket can improve sleep, decrease daytime drowsiness, and reduce insomnia by applying pressure to certain and muscles during sleep.
- Going for a walk as soon as you wake up: Exercising each day may help you sleep better.
For many people with depression, sleep hygiene can only go so far in bringing about meaningful improvements. That's because you're treating symptoms of depression, not the depression itself. If this is the case for you, finding the right depression treatment to support good sleep habits is vital.
Looking beyond Habits: How to Get Help When You Can't Fix a Sleep Issue
For those who have tried depression medications without success, Transcranial Magnetic Stimulation (TMS) offers a drug-free, non-invasive treatment for depression that may help address sleep issues. TMS works by delivering gentle magnetic pulses to mood-regulating brain regions in order to relieve depression symptoms, which may help break cycles of insomnia or oversleeping.
If you're feeling hazy or exhausted due to depression-linked sleep issues, there are treatment options available beyond sleep medications and antidepressants, and TMS may be the option that works for you. To learn more, schedule a no-cost consultation.
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Starting any medical treatment for the first time can leave you with questions, especially if you’re looking forward to the benefits it may bring. It’s no different when you’re preparing for your nasal esketamine treatment. Your previous mental health treatments may have consisted solely of taking antidepressants at home or visiting a therapist’s office for cognitive behavioral therapy (CBT), so nasal esketamine is probably a new treatment experience for you. If you're wondering what it's like to start nasal esketamine and get ready for your first session, keep reading. Getting Started with the Nasal Esketamine Treatment As with any new treatment, you’ll first talk to your primary care provider or psychiatrist about whether nasal esketamine is a good fit for you. Alternatively, you can schedule your esketamine nasal spray consultation with a treatment center (such as Greenbrook) that has certification by the FDA’s Risk Evaluation and Mitigation Strategy (REMS). At Greenbrook's REMS-certified nasal esketamine treatment centers, our Greenbrook-affiliated psychiatrists and psychiatric nurse practitioners will review your medical history and also conduct our own assessment to help determine whether nasal esketamine treatment is right for you. Certain conditions, including blood vessel disease and a history of psychosis, may make treatment a risk for you. Make sure you discuss all previous and present conditions with your doctor or nasal esketamine provider before beginning treatment. If the medication is deemed a good fit, you’ll receive your prescription from the Greenbrook-affiliated provider. Your Greenbrook Care Team will put together a personalized care plan for the weeks and months to follow. Keep in mind that you will need to take a standard (oral) antidepressant along with your nasal esketamine treatment. There are two important regulations to note when it comes to preparing for treatment: Each treatment is followed by a mandatory two-hour observation period. This means you will need to plan to stay at the center for at least two hours following your self-administration of the esketamine nasal spray. You cannot drive during the rest of the day after treatment and must arrange for transportation. These regulations are mandatory. It may be helpful to sit down and plan out several weeks’ worth of transportation once you know your treatment schedule. In addition, if you’re wondering what to bring for the treatment, we recommend entertainment such as an audiobook or playlist of favorite songs and a pair of headphones. You may want them during the two-hour observation period. What to Expect During Nasal Esketamine Treatment On the day of treatment, you’ll need to stop eating any food two hours before your appointment and stop drinking all fluids 30 minutes before you come in. Your Greenbrook Care Team will confirm that you are prepared for the two-hour observation period and that you have a ride home. You’ll get the opportunity to practice using a “trainer sprayer” that mimics the real nasal esketamine sprayer but does not release any medication. The Care Team will encourage you to use the restroom and set up your preferred environment in your private treatment bay or room. Some patients like reduced lighting, for example, while others don’t request light adjustments. You’ll complete a depression scale before each treatment session. Your Greenbrook provider will confirm that the dose kit is yours, show you how to administer it, and then hand it to you. Each sprayer contained 28mg of Spravato esketamine nasal spray. Patients usually start with two sprayers (56mg) and soon increase to 84mg (three sprayers) per treatment. But, your dosage maybe vary. Should you be left with a metallic taste by the spray, the Care Team will offer suckers to help make the flavor dissipate. After your dose, you’ll be encouraged to lie back in your comfortable recliner. While most patients enjoy a quiet setting, Greenbrook is prepared to accommodate patients with a more animated reaction to the medication. You may feel sleepy, dizzy, mildly dissociated, and/or nauseated during treatment. Greenbrook's Care Team is readily available if you need assistance. How to Prepare for after your Nasal Esketamine Treatment Most side effects begin to wane in the second hour of observation, but if you’re wondering, “Is it safe to drive immediately after nasal esketamine treatment?” the answer is a resounding no. In addition to the mandatory ride home, you will need to block off time to rest and let side effects fully dissipate. This extended rest period is especially important in the first weeks of treatment when you’ll have treatment twice a week. Do not drive or operate machinery of any kind until the day after treatment. Just take it easy, relax, and take care of yourself. If you’re unsure what activities you can do or should avoid during this time, talk to your Care Team for more information. While side effects tend to dissipate completely after a good night’s sleep, many nasal esketamine patients begin feeling relief from depression symptoms within hours of their treatment. Other Tips in Preparing for Your Nasal Esketamine Treatment At Greenbrook, we make every effort to schedule your treatment in the afternoons or whenever it is most convenient for you. We encourage you to see each treatment session as an opportunity to relax and take care of your mental health. If you have any questions or concerns, talk to your doctor or the Greenbrook Care Team. At Greenbrook, we’ll help you feel at ease when preparing for each treatment session. Schedule A Free Consultation To get started with nasal esketamine, schedule your free consultation today.
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