"People will get themselves to sleep with or without our help," Dr. Nard said.

These findings suggest that patients with mood disorders should be routinely screened for insomnia. When insomnia is present, treating it simultaneously with the mood disorder may be especially beneficial, Dr. Nard said.

For example, a double-blind, placebo-controlled study of the sleep-aid Ambien (zolipidem) in patients being treated with selective serotonin reuptake inhibitors (SSRIs) for major depression found that Ambien significantly increased total sleep time compared with placebo (P<.05), Dr. Nard said.

For patients with depression and insomnia, an anti-depressant with sedative properties may be helpful, even if the insomnia indication is off-label, Dr. Nard said. For example, a study of depressed patients on an SSRI or Wellbutrin (bupropion) found that when Desyrel (trazodone) was added to the regimen, 65% to 95% of patients reported an objective improvement in seep quality, he said.

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