More than 14 million American adults are diagnosed with depression and the signs and symptoms of depression often overlap with symptoms of some common sleep disorders.

In those who suffer from insomnia, they are ten times more likely to suffer from depression, and ¾ of people who are depressed, also experience symptoms of insomnia. Persons experiencing depression are also five times more likely to have Sleep Disordered Breathing (SDB) such as Obstructive Sleep Apnea (OSA). Likewise, those treated for their SDB, show improvement of their depression symptoms. The two are so closely linked that sleep disturbances have been recognized as a key symptom of depression. The importance of recognizing these symptoms can help to better diagnose and treat your sleep disorder or depression.

Symptoms of Depression

  • Difficulty sleeping
  • Early-morning awakening
  • Oversleeping
  • Irritability
  • Decreased energy or fatigue
  • Difficulty concentrating, remembering, or making decisions
  • Feeling restless or having trouble sitting still
  • Feelings of guilt, worthlessness, or helplessness
  • Persistent sad, anxious or “empty” mood
  • Moving or talking more slowly
  • Loss of interest or pleasure in hobbies and activities
  • Appetite and/or weight change
  • Thoughts of death or suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cuase and/or that do not ease with even treatment

Symptoms of Insomnia

  • Difficulty falling asleep at night
  • Waking up during the night
  • Waking up too early
  • Not feeling well-rested after a night’s sleep
  • Irritability, depression or anxiety
  • Daytime tiredness or sleepiness
  • Difficulty paying attention, focusing on tasks or remembering
  • Increased errors or accidents
  • Ongoing worries about sleep

If you’ve been diagnosed with depression and experience symptoms such as excessive sleepiness, restless sleep, inability to fall asleep or maintain sleep, lack of focus and concentration, or snoring and gasping during sleep, then it may be time to speak with your physician about screening for sleep disorders. Keeping a sleep journal can be helpful in identifying patterns in your sleep that may be symptoms of insomnia. Sleep journals can be found on The National Sleep Foundation page.

Often, treatment of sleep disorders improves the symptoms of depression. In addition to keeping a sleep journal, some other steps that may improve your sleep and depression symptoms include;

  • Keeping a routine sleep schedule
  • Exposure to bright light soon after waking; sunlight is ideal, but light therapy boxes can also be helpful
  • Maintain a healthy diet and exercise regularly; aim for at least 30 minutes a day, but try to avoid exercising late at night which can be disruptive to sleep
  • Limit caffeine and alcohol consumption
  • Screen for sleep disordered breathing such as obstructive sleep apnea

If a diagnosis of insomnia has been made, Cognitive Behavioral Therapy (CBT) can be very beneficial for treatment. CBT is designed to address thoughts and behaviors regarding sleep and can also help in management of depression and SAD symptoms. Your physician may also prescribe an antidepressant to help manage your depression.

It’s important to speak with your physician about the different types of antidepressants and how they may affect you.  Some types of antidepressants such as SSRI’s may worsen symptoms of insomnia and should be carefully considered if restless sleep has been an issue. Occasionally, your doctor may prescribe a short term sleep aid use to help resume a normal pattern of sleep.

Living with poor sleep and depression is difficult, but these symptoms can be managed. The first step is recognizing the symptoms and speaking to your physician.

Brandi Brooks is a sleep technologist at the University of Vermont Medical Center. Learn more about the UVM Medical Center Sleep Center in Burlington, VT.

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