Chronic Insomnia Treatments

A recent study confirms that cognitive behavioral therapy is effective for chronic insomnia and is often more effective than medications. “What surprises us is that there isn’t more awareness of this treatment’s effectiveness and that there haven’t been more attempts to make the treatment more available to patients,” James M. Trauer of the Melbourne Sleep Disorders Centre in Australia told …

Chronotherapy for Depression

Chronotherapy for depression was recently shown to be effective in a fairly large and well designed study from New Zealand. What is chronotherapy? As discussed in the article, which appeared in Acta Scandanavica Psychiatrica, chronotherapy involves some combination of three separate sleep and wakefulness related interventions: Wake therapy. Wake therapy (previously known as “sleep deprivation” therapy, a harder sell to patients) …

CBT for Insomnia Reduces Suicidal Thoughts

CBT for insomnia (CBTi) is clearly preferable to taking sleeping medications for most people. Studies show that cognitive behavioral therapy is associated with greater improvements in sleep quality than sleeping medications, and that those improvements are more durable, and, particularly in the elderly, sleeping medications are associated with significant adverse effects, including an increase in mortality. But it can be a hard …

Sleep Fatigue and Depression

Yesterday I gave a presentation at UCSF to the Mood Disorder Clinic psychiatrists and residents: An Update on Bipolar Depression.  Much of that material is focused on psychopharmacology and so I will be writing about that on the gatewaypsychiatric.com blog. However, one important pearly derives from a series of studies that identify a strong link between sleep and depression. There is frequent …

Sleeping at the Right Time

Sleeping can become a major preoccupation at times of stress, or when one is depressed, or when the seasons change, as they are doing now. We tend to think about sleep as being something that is good for you. The more sleep and the better the quality of that sleep the better off you are. Elsewhere in this blog I’ve …

Fatigue and Depression or Bipolar

Fatigue is a common symptom in people with recurrent depression or bipolar. And in fact a common symptom in the general population. It is estimated that up to 10% of otherwise healthy people suffer from fatigue. And it is a more common symptom in women than in men. Sometimes fatigue may persist well beyond other symptoms of depression. First, it …

Natural Supplements and Insomnia

  There are two herbs or supplements that have the best data supporting their effectiveness. Both appear to be safe but have modest effectiveness. Melatonin Valerian (Alone or Combined with Hops or Melissa) Melatonin: Rapid Effect on Sleep The body uses melatonin as part of the way it regulates the sleep-wake cycle. Levels of melatonin increase as light decreases (at …

Sleep and the Lunar Cycle

One of our readers wondered if bipolar people are more sensitive to lunar cycles. I could not find any evidence for that, but I did run across a recent research report suggesting that everyone (bipolar or not) may have a sleep cycle that corresponds to the phase of the moon. Researchers at the University of Basel studied 33 people and …

Internet Therapies Generate Interest

There is increasing interest in “apps” that can support mental health (one of our most enthusiastic readers recently posted a query on this topic on the forum). Apps are rarely intended to deliver “therapy” – they are usually not written by mental health professionals (although mental health professionals may be consulted along the way). Their goal is to be appealing …

Using a Therapy Light

Christmas vacation is ending, It has been wonderful to spend some relaxing time with family, getting up later in the day, lounging around and playing games, reading, or watching TV… and eating too much good food. Now the challenge is getting back to a more productive schedule. For many of us, our bodies are in a “hibernating” mode that makes …

Sleep Therapy and Depression

What would you do if you could double the effectiveness of your antidepressants? Let’s say that this new treatment also had no known side effects, and was completely safe. That is what four studies have suggested could happen if people who were started on antidepressants received cognitive behavioral therapy for insomnia (CBTi). However, this treatment is not widely available. We …

“Normal” Sleep

One of the justifiable criticisms of psychiatry is that it has a tendency to define a relatively narrow range of behavior as normal. We often tell the psychiatry residents to watch out for this tendency, and try to avoid it. Certainly sleep medicine is at least as prone to this tendency as psychiatry, as we are reminded by a fascinating …

Treatment for Insomnia when Bipolar

Many people with bipolar disorder also experience symptoms of insomnia and sleep disturbance.  Researchers have been investigating treatments for this condition that do not involve medications. After numerous clinical trials, there has been significant success with CBT-I treatment. CBT-I is cognitive behavioral therapy for insomnia and it involves sleep restriction and stimulus control. The purpose of the first treatment is …

SHUTi: Work towards a better night’s sleep

Having trouble sleeping? We think the website SHUTi may be helpful to you. Sleep is a crucial component for the happiness and well being of an individual. An appropriate amount of sleep can lower anxiety levels, help prevent overeating, and improve memory. On the moodsurfing website, we recommend SHUTi as a resource to individuals struggling with insomnia. SHUTi provides an …

Sleep Strategies

One of the most frequent causes of insomnia is anxiety. Insomnia of this kind is caused by increased activation of the sympathetic nervous system at night. The body releases norepinephrine (the flight or fight hormone) at night when that system should be inactive. You wake up and you feel “wide awake.” A current patient of Dr. Forster’s is having difficulty sleeping …