Effect of insomnia treatments on depression: A systematic review and meta-analysis

Marie Anne Gebara, Nalyn Siripong, Elizabeth A. DiNapoli, Rachel D. Maree, Anne Germain, Charles F. Reynolds, John W. Kasckow, Patricia M. Weiss, Jordan F. Karp

Research output: Contribution to journalReview articlepeer-review

133 Scopus citations


Background: Insomnia is frequently co-morbid with depression, with a bidirectional relationship between these disorders. There is evidence that insomnia-specific interventions, such as cognitive behavioral therapy for insomnia, may lead to improvements in depression. The purpose of this systematic review and meta-analysis is to determine whether treatment of insomnia leads to improved depression outcomes in individuals with both insomnia and depression. Methods: We conduct a systematic review and meta-analysis to explore the effect of treatment for insomnia disorder on depression in patients with both disorders. Results: Three thousand eight hundred and fifteen studies were reviewed, and 23 studies met inclusion criteria. Although all of the studies suggested a positive clinical effect of insomnia treatment on depression outcomes, most of the results were not statistically significant. Although the interventions and populations were highly variable, the meta-analysis indicates moderate to large effect size (ES) improvement in depression as measured with the Hamilton Depression Rating Scale (ES = −1.29, 95%CI [−2.11, −0.47]) and Beck Depression Inventory (ES = −0.68, 95%CI [−1.29, −0.06]). Conclusions: These results support that treating insomnia in patients with depression has a positive effect on mood. Future trials are needed to identify the subtypes of patients whose depression improves during treatment with insomnia-specific interventions, and to identify the mechanisms by which treating insomnia improves mood.

Original languageEnglish (US)
Pages (from-to)717-731
Number of pages15
JournalDepression and Anxiety
Issue number8
StatePublished - Aug 2018
Externally publishedYes


  • cognitive therapy
  • comorbidity
  • depressive disorder
  • major
  • remission induction
  • sleep initiation and maintenance disorders

ASJC Scopus subject areas

  • Clinical Psychology
  • Psychiatry and Mental health


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