Sleep deprivation can rapidly reduce depression symptoms in some patients

Paul Basilio, MDLinx | September 20, 2017

The first meta-analysis of the effect of sleep deprivation on depression in nearly 30 years has shown that controlled, in-patient treatment can rapidly reduce symptoms in roughly half of all patients. The findings were published in the Journal of Clinical Psychiatry.

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Additional research is needed to identify precisely how sleep deprivation causes rapid and significant reductions in depression severity.

Researchers at the Perelman School of Medicine at the University of Pennsylvania showed that partial sleep deprivation—3 to 4 hours of sleep followed by forced wakefulness for 20-21 hours—was as effective as total sleep deprivation for 36 hours. Medication did appear to have a significant influence on the outcomes.

Total or partial sleep deprivation can produce a clinical improvement in depression symptoms within 24 hours. Antidepressant medications are the most common treatment for patients with depressive order, but the drugs can often take weeks to register an effect.

Prior results have shown rapid antidepressant effects from sleep deprivation for approximately 40% to 60% of patients, but the response rate has not been analyzed for a more precise figure since 1990.

“More than 30 years since the discovery of the antidepressant effects of sleep deprivation, we still do not have an effective grasp on precisely how effective the treatment is and how to achieve the best clinical results,” said study senior author Philip Gehrman, PhD, an Associate Professor of Psychiatry and member of the Penn Sleep Center, who also treats patients at the Cpl. Michael J. Crescenz VA Medical Center. “Our analysis precisely reports how effective sleep deprivation is and in which populations it should be administered.”

The team reviewed more than 2,000 studies and analyzed data from a final group of 66 studies that were performed over a 36 year period. They looked to determine how response may be affected by the type and timing of sleep deprivation (ie, total vs early or late partial sleep deprivation), the clinical sample, medication status, and age and gender of the sample. They also investigated whether the response to sleep deprivation may differ across studies according to how “response” is defined in each study.

“These studies in our analysis show that sleep deprivation is effective for many populations,” said lead author Elaine Boland, PhD, a Clinical Associate and Research Psychologist at the Cpl. Michael J. Crescenz VA Medical Center. “Regardless of how the response was quantified, how the sleep deprivation was delivered, or the type of depression the subject was experiencing, we found a nearly equivalent response rate.”

Additional research is needed to identify precisely how sleep deprivation causes rapid and significant reductions in depression severity. Authors note that future studies will also need to include a more comprehensive assessment of potential predictors of treatment outcome to identify those patients most likely to benefit from sleep deprivation.

To read more about the study, click here.

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