The effect of non-pharmacological sleep interventions on depression symptoms: A meta-analysis of randomised controlled trials


sleep is a significant risk factor for depression across the lifespan
and sleep problems have been hypothesised to contribute to the onset and
maintenance of depression symptoms. However, sleep problems are usually
not a direct target of interventions for depression. A range of
non-pharmacological treatments can reduce sleep problems but it is
unclear whether these interventions also reduce other depression
symptoms. The aim of this review was to examine whether
non-pharmacological interventions for sleep problems are effective in
reducing symptoms of depression. We carried out a systematic search for randomised controlled trials
of non-pharmacological sleep interventions that measured depression
symptoms as an outcome. Forty-nine trials (n = 5908) were included in a
random effects meta-analysis. The pooled standardised mean difference
for depression symptoms after treatment for sleep problems was −0.45
(95% CI: −0.55,−0.36). The size of the effect on depression symptoms was
moderated by the size of the effect on subjective sleep quality. In
studies of participants with mental health problems, sleep interventions
had a large effect on depression symptoms (d = −0.81, 95%
CI: −1.13,−0.49). The findings indicate that non-pharmacological sleep
interventions are effective in reducing the severity of depression,
particularly in clinical populations. This suggests that
non-pharmacological sleep interventions could be offered as a treatment
for depression, potentially improving access to treatment.

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