• A 20 minute afternoon nap – my standard duration – has been proven to boost concentration more than a coffee. (AAP)Source: AAP
A world-first study has uncovered that depression can be prevented using an online insomnia therapy program that is now available for purchase in Australia.
Yasmin Noone

28 Jan 2016 - 4:40 PM  UPDATED 28 Jan 2016 - 4:41 PM

A form of online Cognitive Behaviour Therapy (CBT) designed to treat insomnia may prevent people from experiencing major depressive episodes, sometimes before symptoms even present.

Australia’s Black Dog Institute, in partnership with researchers from the Australian National University, University of Sydney and the American University of Virginia, recently trialled an online CBT-based insomnia intervention called ‘SHUTi’ on 500 men and women.

Meanwhile, 500 more participants were allocated to another online program containing information about general health.

The results, published today in the journal Lancet Psychiatry, showed that the treatment group experienced significantly reduced insomnia, anxiety and depression, with improvements in mood, sleep and mental health lasting at least six months.

"The novelty of this study is that if you have someone who has insomnia or they have depression symptoms, if you treat the insomnia it will prevent them from getting depression."

Chief investigator Professor Helen Christensen has labelled the trial as a world-first discovery into depression prevention.

"The novelty of the study is not to say that online therapy can treat depression or insomnia because we know those things from previous research already," says Prof Christensen.

"The novelty of this study is that if you have someone who has insomnia or they have depression symptoms, if you treat the insomnia it will prevent them from getting depression."

SHUTi (Sleep Healthy Using the Internet) has been made available for sale to Australians with insomnia and those at risk of depression via the Black Dog Institute.

A successful negotiation between via the Black Dog Institute and the University of Virginia means that Australians can access program for around $170.

The course, delivered by automated software, contains six modules and runs for around 16-weeks. It requires about one-to-two hours attention a week and users only need basic computer literacy skills.

Participation involves completing a sleep diary every day for the first two weeks of the program.

Users receive tailored treatment as SHUTi provides personalised tips and lifestyle instructions to counteract insomnia, such as restricting when the person is allowed to sleep.

"By restricting when you are able to sleep, it builds up some sleep deprivation at the beginning," Prof Christensen says.

The evidence-based program uses CBT to teach users methods to manage particular thoughts that might keep them awake at night.


The insomnia-depression link

According to beyondblue, depression is the leading cause of disability worldwide.

In any one year, around one million Australian adults will have depression. On average, one in six people (one in five women and one in eight men) will experience depression at some stage of their lives.

The Black Dog Institute states that around 80 per cent of people diagnosed with depression also experience insomnia.

Around 40 per cent of those suffering insomnia may also have undiagnosed yet clinically significant depressive symptoms.

Prof Christensen says the link between depression and insomnia is complex: insomnia is closely associated with many mental illnesses, both as a symptom and a potential trigger.

"Insomnia and depression are very commonly linked with each other but no one knows if they have the same biological mechanism.

"Insomnia is a sign that you might be at risk of depression, especially if you have the symptoms of depression but haven’t got a diagnosis yet.

"So, just as we have sunscreen to prevent the development of skin cancer, the use of an insomnia treatment like SHUTi before depression symptoms escalate will essentially prevent transition into major depression, saving costs and lives."

Prof Christensen believes online depression solutions will prove effective for Australians who lack access to medical professionals and those who do not want to physically visit a clinical setting for treatment.

"People will often seek help for insomnia but they won’t seek help for depression. They are more open to saying ‘I can’t sleep’ because that’s easier than saying ‘I am feeling down’.

"This program is also of significant importance for young people, who may not be able to specifically identify depression symptoms but are aware of their insomnia."

The trial also found that SHUTi reaped the same level of effects expected of face-to-face treatment.


If you are in need of support or want to talk to someone, please call Lifeline on 13 11 14 or visit beyondblue's website.