Brand New CBTi Data - it works for Depression too!

As a health practitioner, I never stop reading and learning. Every now and then, I need to dive into the research and see what's current. This week, I was reviewing insomnia, to see if I can apply any new knowledge to my clients. Lo and behold, we have a new systematic review and meta-analysis on CBTi, and (phew) it's a good one.

Firstly, for those of us who don't have to read research for a living, I'll break down what systematic review and meta-analysis are. Why? Because knowledge is power! And I think being a well-rounded human means knowing how things work. Plus, the more you research, the better informed you are about your health choices! So here we go:

A systematic review is a type of research where scientists look at all the studies on a specific topic to get a full understanding of what the evidence says. They follow a set process to find, evaluate, and summarise all the studies that meet certain criteria. This process ensures that they include all relevant research, not just the studies they happen to come across or prefer.

Once all the relevant studies are together, a meta-analysis is a way of combining the results from multiple studies to get a clearer answer. Imagine that different researchers studied the same question but came up with slightly different results. In a meta-analysis, scientists gather all those individual studies, analyse their data together, and come up with an overall conclusion. This helps to get a more accurate and reliable answer than any single study could provide on its own. I like to think of it the same way we assess the validity of gossip - hear it from one person, ok, maybe it's true. Hear the same thing from multiple people? Oh yeah, it definitely happened.

In short, this process is like a very thorough, unbiased summary of everything scientists know about a topic, giving a clear and balanced overview of what the research, as a whole, says.

Now to the research at hand. A study from Japan has shown that CBTi, along with showing benefits for insomnia, can also be used to treat major depressive disorder (MDD). The study includes 19 trials (the largest on this topic to date) with 4808 participants, and showed that CBTi significantly improves depressive symptoms and insomnia remission compared to control conditions. This is because, for most people, insomnia causes significant emotional distress, so there is a strong link between lack of sleep and mood disorders. The study even opens with “insomnia often preceded the first depressive episode.”

The findings suggest that CBTi can be a valuable treatment option, especially when insomnia causes significant distress. And let’s be real – when does it not? Struggling with sleep effects every part of your life; mood, hormones, appetite, energy, relationships, motivation, fitness... the list goes on.

Why is CBTi so useful for both insomnia and depression? The study gives three main reasons. Firstly, it is applicable in a range of settings, ages and circumstances which gives great flexibility to practitioners. Secondly, it is reasonably simple to explain to patients and for patients to carry out at home. Thirdly, lots of people are willing to try CBTi under the banner of ‘helping my sleep’ rather than for depression, as sleep is easier to talk about. That last point is so important. We still have so much taboo around mental health, so something seemingly physical like insomnia (spoiler alert, it’s not physical), is easier to discuss.

Now, this paper does admit a weakness; some of the studies did show dropout rates for CBTi. This suggests to me that it might be better to seek out a CBTi practitioner, rather than an app. But apps do have their place, and are more affordable, which is important to remember.

This current research was interesting to read, as it opens the door for other effective therapies for Depressive conditions, outside the realm of medication. I have seen depression medications be life saving, so that's important to state. I will also say that a lot of my clients have experienced significant side effects from their medicines, and are often looking for other options - perhaps even as a compliment to their current regime.

Want to read a bit more about CBTi? You can do so via the Sleep Foundation, or on a previous blog post of mine. If you do nothing else, try to make sleep a priority in your life.

At the end of the day, if you think that you might be struggling with insomnia or depression, I encourage you to seek out some professional support. It really is worth talking with a GP that you trust, to get the best idea for where to get help. While I love using CBTi, it may not be the right fit for you or perhaps it’s not the right time, and there’s nothing wrong with that! There are loads of remedies and practitioners out there to help you.