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The potential pathway between insomnia and depression

depression from insomnia

Have you ever had to deal with bouts of insomnia make you feel depressed? Well the good news is you’re not alone, in fact the two may be linked. A new study of firefighters suggests that insomnia and nightmares may increase the risk of depression by impairing the ability to access and leverage emotion regulation strategies effectively.

Results show that a high percentage of participants reported clinically significant insomnia symptoms (52.7 percent), depression symptoms (39.6 percent) and nightmare problems (19.2 percent). Further analyses revealed that the indirect effects of overall emotion regulation difficulties were significant both for the relationship between insomnia and depression and nightmares and depression. Limited access to emotion regulation strategies – such as problem-solving skills and the ability to decrease negative emotions – emerged as the strongest, most significant indirect effect for both relationships.

“Our study findings suggest that firefighters with sleep difficulties are likely to experience greater struggles accessing strategies to regulate their emotions, especially when feeling upset. This, in turn, may lead to or worsen feelings of depression and low mood,” said lead author Melanie Hom.

“These results are important because they provide a plausible explanation for why and how sleep problems may contribute to depression, which are critical questions for prevention and intervention.”

According to the American Academy of Sleep Medicine, transient insomnia symptoms occur in 30 to 35 percent of the population. Chronic insomnia, which occurs at least three times per week for at least three months, affects about 10 percent of adults. Approximately 2 to 8 percent of the general population has a current problem with nightmares, and trauma-related nightmares are the most consistent problem reported by people who have post-traumatic stress disorder.

Led by Hom and under the supervision of Dr. Thomas Joiner, the research team analyzed responses from 880 current and retired United States firefighters between the ages of 18 and 82 years. Participants completed a web-based survey of behavioral health. Self-report measures included the Center for Epidemiologic Studies Depression Scale, Insomnia Severity Index, PTSD Checklist, and Difficulties in Emotion Regulation Scale.

“Firefighters are typically faced with many demands, including difficult work schedules, and they often both witness and experience traumatic events,” said Hom.

“It is not surprising that firefighters may experience sleep problems and depression, but it is critical that greater efforts be made to prevent and treat these problems.”

According to the authors, the findings suggest that emotion dysregulation may be an important therapeutic target for reducing depression risk among firefighters and other individuals who experience insomnia and nightmares.

Hom, M., Stanley, I., Rogers, M., Tzoneva, M., Bernert, R., & Joiner, T. (2016). The Association between Sleep Disturbances and Depression among Firefighters: Emotion Dysregulation as an Explanatory Factor Journal of Clinical Sleep Medicine, 12 (02), 235-245 DOI: 10.5664/jcsm.5492

11 responses

  1. Lack of sleep cause psychosis too


    February 17, 2016 at 2:27 pm

    • It’s the catch-22 to the whole problem, does psychosis cause lack of sleep or does lack of sleep cause psychosis. But really if it’s the same pathway in the brain then it’s petty much one in the same.

      Liked by 1 person

      February 17, 2016 at 3:10 pm

  2. It is a catch-22, as I had a similar thought when I started reading this post, does depression cause insomnia or does insomnia cause depression. Due to my own experience, I would have to say that it goes both ways.


    February 17, 2016 at 4:57 pm

    • Yeah and in that way it is kind of frustrating, fix one problem and the other seems to creep back up…


      February 19, 2016 at 12:10 pm

  3. scc

    Sleep disorders are a major problem for a lot of people, especially for people with PTSD. My uncle has PTSD from being in the military, and is now a firefighter/ police officer. He developed insomnia and now has depression as well. Since his job has very different hours causing different sleep schedules and with having insomnia makes things very difficult. His body and mind is run down, being tired is worse than being drunk when you are that sleep deprived. Because of this he also has trouble dealing with his emotions, causing him to develop depression. I would love to see greater efforts to prevent and treat these problems. So many people suffer from these things, and it is life altering. I really enjoyed reading this post.


    February 18, 2016 at 8:22 pm

    • Well I’m sorry to hear about your uncle’s situation. But thank you for taking the time to share your story.I agree greater efforts are needed, but every step forward is progress at least.


      February 19, 2016 at 12:13 pm

  4. SCCC Student 206648

    Many people often have nightmares in which they cannot control the situation they are trying to deal with. It sounds like this may have been the case with the firefighters and part of their insomnia. This can be a problem for a lot of people, but I wonder if training people with insomnia to learn how to lucid dream would help. Lucid dreaming has shown to give the dreamer more feelings of control and relaxation. Lucid dreaming can also help the subconscious in figuring out the underlying meanings of the nightmares (more specific than “you’re worried about a lack of control”). As someone who has practiced in lucid dreaming I can say that when I lucid dream I always feel empowered by controlling my dream and I wake up excited to see what the rest of the day has in store. These benefits sound like a well-matched remedy for insomniacs.
    For the firefighters in particular who may work both day and night shifts, they are also interrupting their Circadian rhythms. To go from a peaceful sleep to suddenly having to jump out of bed and becoming fully alert sounds exhausting to say the least. Not having a natural circadian rhythm, and dealing with stressful work for long hours would cause depression, if not insanity, for anyone. Obviously more research needs to be done to find better solutions for people who have to do such life-risking jobs.


    February 20, 2016 at 9:29 pm

  5. I found this really interesting because I think they do relate together, because the lack of sleep causes me to become crabby and it definitely could lead to depression. But I know many people have sleeping disorders and thats related to PTSD. One of my really good friends has PTSD and he has a serious problem with not just sleeping but also with nightmares. But I know, that since he struggles with talking about his PTSD, I feel like that makes him feel almost depressed because he doesn’t want to talk about it. I just find it kind of crazy that it all can tie in together!


    February 21, 2016 at 2:36 pm

    • I’m sorry to hear about your friend, I’ve had similar issues and if it makes you feel any better, it is hard to talk about and frankly sometimes doesn’t help, at least not in that moment.

      It is very interesting that it all ties together and I’m excited to see what will come next for the research.

      Sorry for the delay in response, it’s been a bit busy here at the lab.


      February 24, 2016 at 11:55 am

  6. Ashley

    There are so many people who suffer from depression and insomnia. Too often, I think that people are prescribed drugs that will solve their issues on a surface level. By blocking certain pathways in the brain, the drugs make it easier to cope with the issues by blocking serotonin reabsorption, but it does not solve them. This study highlighted the emotional damages faced by firefighters and how it affects their lives. The same insomnia and depression is seen in military veterans and police officers. I am happy to see that mental health awareness has gained support from the community, because I think it is not often talked about, and it affects so many people. I think that in order to heal the emotional dysregulation, they need to confront their previous conflicts, and not mask them with different medicines. Not that I don’t believe in medication for mental illnesses, I just think that cognitive behavioral therapy would also help these people affected with insomnia and depression, especially those whom often suffer with PTSD. I think it was an interesting study, and as mentioned in the comments, I think that both depression and insomnia are probably affected by the same pathway, just as many others do, such as ADHD and anxiety. I also would be interested in seeing what other types of therapy are effective for these patients such as electroconvulsive therapy or the use of alternative medicines such as ayahuasca psychedelics.


    February 21, 2016 at 8:41 pm

    • I agree with a lot of what you are saying, as a Marine vet myself I can relate to the article personally. I do think medication is a good thing and I sing its praise on a regular basis, but I do think that there are other things that should be done alongside, once we have a better understanding of the brain, we may actually just be able to go in and fix the damage outright, which would be a nice outcome.

      I think the research into psychedelics for depression and mental illness is fascinating too and you can be sure that if something new comes out you’ll probably see it here.

      Sorry it took so long to respond, we’re backed up here at the lab with our projects.


      February 24, 2016 at 11:53 am

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