Application of automated REM and slow wave sleep analysis: II. Testing the assumptions of the two-process model of sleep regulation in normal and depressed subjects

Kupfer, David J.; Ulrich, Richard F.; Coble, Patricia A.; Jarrett, David B.; Grochocinski, Victoria J.; Doman, Jack; Matthews, G. A.; Borbély, Alexander A.

doi:10.1016/0165-1781(84)90081-7

Cited by 96 publications

(25 citation statements)

References 6 publications

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“…Thus, we cannot confirm Kupfer et al's findings of lower delta wave counts in depression. [16][17][18][19] However, Kupfer's group focuses on high-amplitude delta waves (>75 V), perhaps accounting for the discrepancies in findings. Nevertheless, our earlier report, 20 based on high-amplitude delta waves also failed to reveal abnormal delta incidence and ratios in those with MDD.…”

Section: Discussionmentioning

confidence: 99%

“…In several studies, they have reported lower delta wave counts in patients with MDD compared to controls, but these differences were largely restricted to the first non-rapid eye movement (NREM) period of the night. [16][17][18] In fact, Kupfer's group has suggested that delta wave counts in patients with MDD are higher in the second NREM period than in the first, and that this delta ratio is related to the clinical course of illness. 19 A more recent study has been unable to replicate either lower delta wave counts or an elevation in delta in the second NREM period in patients with MDD.…”

Section: A Considerable Number Of Studies Have Indicated That Major Dmentioning

confidence: 99%

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Temporal Characteristics of Delta Activity During NREM Sleep in Depressed Outpatients and Healthy Adults: Group and Sex Effects

Armitage

Hoffmann

Fitch

et al. 2000

Sleep

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A CONSIDERABLE NUMBER OF STUDIES HAVE INDICATED THAT MAJOR DEPRESSIVE DISORDER (MDD) is characterized by difficulties initiating and maintaining sleep, increased stage 1 sleep, an early onset of rapid eye movement (REM) sleep, increased phasic REM activity, and a reduction in slow-wave (stage 3-4) sleep (cf. 1). However, a recent meta-analysis has indicated that no single sleep variable reliably differentiates depressed patients from healthy controls. 2 Moreover, not all studies, particularly more recent work, have shown significant differences between patients and controls. 3-4 Short REM latency (<65 minutes) and/or reduced slow-wave (SW) sleep, for example, are only present in 40%-60% of outpatients with MDD. As suggested recently, it is very likely that confounds such as age and sex have contributed to discrepant outcomes in sleep studies of MDD, most notably with regard to slow-wave sleep and measures of delta EEG activity (cf. 3-5). This issue is a key focus of the present paper.Work on REM and SW sleep abnormalities has led to speculation that sleep regulatory processes are disrupted in MDD. Specifically, the regulatory disturbance has been postulated as one of REM disinhibition, due to an imbalance in cholinergic-aminergic neurotransmitters that leads to both the early onset of REM and increased phasic REM activity. 6 There is fairly strong evidence that MDD is associated with increased cholinergic sensitivity using critical REM induction tests. To date, there is little evidence to refute this theory of sleep disturbance in MDD, although cholinergic sensitivity may not be specific to depression. 4 Others have suggested that the circadian oscillator that controls temperature, neuroendocrine function, and REM sleep is phase-advanced relative to SW sleep. 7-8 More recent evidence indicates that MDD is more likely to be associated with blunted amplitude circadian rhythms, 9Study Objectives: The primary aim was to evaluate group and sex differences in delta activity across non-rapid eye movement (NREM) sleep in depressed patients and healthy controls. Design: Repeated-measures ANOVA contrasted delta power, amplitude and incidence in the first three NREM periods (stages 2,3, and 4) of sleep. The time course of delta activity was evaluated with exponential regressions. Age effects on delta were evaluated with linear regression analysis. Setting: Two consecutive nights were spent in the laboratory, the first of which served as adaptation. Patients or Participants: Twenty-two (9 men, 13 women) symptomatic, but unmedicated, outpatients with major depressive disorder (MDD) and 23 healthy controls (15 men, 8 women) participated in the study. Measurements and Results: Delta power and amplitude showed significant group by sex interactions. Men with MDD showed lower power and amplitude in NREM sleep compared to women with MDD, but did not differ significantly from controls. However, the time course of delta power and amplitude was significantly different in men with MDD, with lower accumulation and slower dissipation ac...

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Section: Discussionmentioning

confidence: 99%

Section: A Considerable Number Of Studies Have Indicated That Major Dmentioning

confidence: 99%

Temporal Characteristics of Delta Activity During NREM Sleep in Depressed Outpatients and Healthy Adults: Group and Sex Effects

Armitage

Hoffmann

Fitch

et al. 2000

Sleep

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“…Electroencephalographic (EEG) studies in major depression report abnormalities in sleep architecture, including prolonged sleep latency, shortened rapid eye movement (REM) sleep latency and increased REM sleep, decreased slow-wave sleep and EEG slow-wave activity, and a higher rate of awakenings, particularly towards the end of the night sleep episode (Armitage, 2007;Armitage & Hoffmann, 1997;Berger & Riemann, 1993;Borbély et al, 1984;Germain et al, 2004;Knowles et al, 1982;Kupfer et al, 1984;Reynolds & Kupfer, 1987). Interestingly, most of these changes in sleep architecture are also typically observed in healthy aging without depressive symptomatology, and it has been argued that sleep in depression bears similarities to precocious aging (Gillin et al, 1981).…”

Section: Introductionmentioning

confidence: 95%

Young Women With Major Depression Live on Higher Homeostatic Sleep Pressure Than Healthy Controls

Frey

Birchler-Pedross

Hofstetter

et al. 2012

Chronobiology International

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There is mounting evidence for the involvement of the sleep-wake cycle and the circadian system in the pathogenesis of major depression. However, only a few studies so far focused on sleep and circadian rhythms under controlled experimental conditions. Thus, it remains unclear whether homeostatic sleep pressure or circadian rhythms, or both, are altered in depression. Here, the authors aimed at quantifying homeostatic and circadian sleep-wake regulatory mechanisms in young women suffering from major depressive disorder and healthy controls during a multiple nap paradigm under constant routine conditions. After an 8-h baseline night, 9 depressed women, 8 healthy young women, and 8 healthy older women underwent a 40-h multiple nap protocol (10 short sleep-wake cycles) followed by an 8-h recovery night. Polysomnographic recordings were done continuously, and subjective sleepiness was assessed. In order to measure circadian output, salivary melatonin samples were collected during scheduled wakefulness, and the circadian modulation of sleep spindles was analyzed with reference to the timing of melatonin secretion. Sleep parameters as well as non-rapid eye movement (NREM) sleep electroencephalographic (EEG) spectra were determined for collapsed left, central, and right frontal, central, parietal, and occipital derivations for the night and nap-sleep episodes in the frequency range .75-25 Hz. Young depressed women showed higher frontal EEG delta activity, as a marker of homeostatic sleep pressure, compared to healthy young and older women across both night sleep episodes together with significantly higher subjective sleepiness. Higher delta sleep EEG activity in the naps during the biological day were observed in young depressed women along with reduced nighttime melatonin secretion as compared to healthy young volunteers. The circadian modulation of sleep spindles between the biological night and day was virtually absent in healthy older women and partially impaired in young depressed women. These data provide strong evidence for higher homeostatic sleep pressure in young moderately depressed women, along with some indications for impairment of the strength of the endogenous circadian output signal involved in sleep-wake regulation. This finding may have important repercussions on the treatment of the illness as such that a selective suppression of EEG slow-wave activity could promote acute mood improvement.

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“…Indeed, the process S-deficiency hypothesis for MDD has contradictory findings in sleep and wake EEGs. An early study observed lower delta waves during sleep in depressed patients without excluding for sleep disturbances [10]. In a similar vein, this finding was later observed in MDD individuals, albeit only in men [5].…”

Section: Introductionmentioning

confidence: 62%

Subjective Mood in Young Unmedicated Depressed Women under High and Low Sleep Pressure Conditions

Birchler-Pedross

Frey

Götz

et al. 2016

Biology

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Diurnal mood variations are one of the core symptoms in depression, and total sleep deprivation (SD) can induce rapid, short-lasting clinical improvement in depressed patients. Here, we investigated if differential sleep pressure conditions impact on subjective mood levels in young women with major depressive disorder (MDD) without sleep disturbances, and in healthy controls. Eight healthy and eight MDD women underwent 40-h SD (high sleep pressure) and 40-h multiple NAP (low sleep pressure) protocols under constant routine conditions during which subjective mood was assessed every 30-min. MDD women rated overall significantly worse mood than controls, with minimal values for both groups during the biological night (ca. 4 a.m.), under high and low sleep pressure conditions. During SD, nighttime mood ratings in MDD women were lower than in controls and partially recovered during the second day of SD, but never attained control levels. The degree of this diurnal time-course in mood under SD correlated positively with sleep quality in MDD women. Our data indicate that MDD women without sleep disturbances did not exhibit a SD-induced antidepressant response, suggesting that the mood enhancement response to sleep deprivation might be related to the co-existence of sleep disturbances, which is an association that remains to be fully established.

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Application of automated REM and slow wave sleep analysis: II. Testing the assumptions of the two-process model of sleep regulation in normal and depressed subjects

Cited by 96 publications

References 6 publications

Temporal Characteristics of Delta Activity During NREM Sleep in Depressed Outpatients and Healthy Adults: Group and Sex Effects

Temporal Characteristics of Delta Activity During NREM Sleep in Depressed Outpatients and Healthy Adults: Group and Sex Effects

Young Women With Major Depression Live on Higher Homeostatic Sleep Pressure Than Healthy Controls

Subjective Mood in Young Unmedicated Depressed Women under High and Low Sleep Pressure Conditions

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