Electroencephalographic Sleep and Hypothalamic–Pituitary–Adrenal Changes from Episode to Recovery in Depressed Adolescents

Rao, Uma; Poland, Russell E.

doi:10.1089/cap.2008.034

Cited by 44 publications

(44 citation statements)

References 64 publications

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“…After remission, no changes in sleep variables were found. 26 These findings support the hypothesis that persisting sleep EEG changes in remitted patients may represent a biological scar.…”

Section: Controlssupporting

confidence: 75%

“…25 Similar results were reported in depressed adolescents. 26 They showed reduced sleep efficiency, shorter REM latency, and elevated REM density in comparison to healthy subjects. After remission, no changes in sleep variables were found.…”

Section: Controlsmentioning

confidence: 94%

“…[30][31][32] In contrast, other studies reported similar changes in depressed adults, children, and adolescents. 26,33,34 Kupfer and Foster submitted the hypothesis that a shortened REM latency is a specific marker of depression.…”

Section: Controlsmentioning

confidence: 99%

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Sleep electroencephalography as a biomarker in depression

Steiger¹,

Pawlowski²,

Kimura³

2015

CPT

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Abstract:The sleep electroencephalogram (EEG) provides biomarkers of depression, which may help with diagnosis, prediction of therapy response, and prognosis in the treatment of depression. In patients with depression, characteristic sleep EEG changes include impaired sleep continuity, disinhibition of rapid-eye-movement (REM) sleep, and impaired non-REM sleep. Most antidepressants suppress REM sleep in depressed patients, healthy volunteers, and in animal models. REM suppression appears to be an important, but not an absolute requirement, for antidepressive effects of a substance. Enhanced REM density, a measure for frequency of REM, characterizes high-risk probands for affective disorders. REM-sleep changes were also found in animal models of depression. Sleep-EEG variables were shown to predict the response to treatment with antidepressants. Furthermore, certain clusters of sleep EEG variables predicted the course of the disorder for several years. Some of the predicted sleep EEG markers appear to be related to hypothalamic-pituitary-adrenal system activity.

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“…After remission, no changes in sleep variables were found. 26 These findings support the hypothesis that persisting sleep EEG changes in remitted patients may represent a biological scar.…”

Section: Controlssupporting

confidence: 75%

Section: Controlsmentioning

confidence: 94%

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Sleep electroencephalography as a biomarker in depression

Steiger¹,

Pawlowski²,

Kimura³

2015

CPT

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“…Possibly our findings can be explained by the relatively old age of our sample, as REM sleep latency tends to become progressively shorter with middle age, while REM density does not vary with age (Lauer et al, 1991). In addition, it has been suggested that REM density is altered in both remittent and depressive states (Rao and Poland, 2008), which might explain this association in the present subclinical population where depressive symptoms are less severe but continuously lingering. Research on high-risk probands demonstrated that REM density is also elevated in healthy relatives of patients with depression, and that elevated REM density is predictive for the onset of psychiatric disorders (Modell et al, 2005).…”

Section: Discussionmentioning

confidence: 55%

REM sleep and depressive symptoms in a population‐based study of middle‐aged and elderly persons

Luik

Zuurbier

Whitmore

et al. 2015

Journal of Sleep Research

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SUMMARYAlterations in rapid eye movement sleep have been consistently related to depression in clinical studies. So far, there is limited evidence from population-based studies for this association of rapid eye movement sleep alterations with depressive symptoms. In 489 participants of the Rotterdam Study, we assessed rapid eye movement sleep latency, rapid eye movement sleep duration and rapid eye movement density with ambulant polysomnography, and depressive symptoms with the Center of Epidemiologic Studies-Depression Scale. A longer rapid eye movement sleep latency (B = 0.002, P = 0.025) and higher rapid eye movement density (B = 0.015, P = 0.046) were related to depressive symptoms after age-sex adjustment. When we excluded persons who used sleep medication or medication for the nervous system (n = 124), only rapid eye movement density remained related to depressive symptoms (B = 0.018, P = 0.027). Our results suggest that rapid eye movement density is a marker of depressive symptoms in the general population, and that associations of rapid eye movement sleep with depressive symptoms are modified by the use of medication. IN TROD UCTI ONClinical research suggests that a decreased rapid eye movement (REM) sleep latency, increased REM sleep duration and increased REM density are prominent in persons with depressive disorders (Palagini et al., 2013). Changes in sleep are found during and before the onset of depressive disorders, suggesting that sleep alterations can be both a trait and state marker (Pillai et al., 2011).Studies on the associations of REM sleep and depression have been conducted in clinical populations with severe depressive episodes mostly. However, in the general population, symptoms of depression are usually lingering and less severe. In two large population-based studies, no associations of REM sleep with depressive symptoms were found (Castro et al., 2013;Kravitz et al., 2011). In a large sample of older men, a lower percentage of time spent in REM sleep was related to more depressive symptoms (Smagula et al., 2013).Clinical studies typically investigate medication-na€ ıve patients, as sleep medication and other medication can impact REM sleep (Wilson and Argyropoulos, 2005). Population-based studies mostly adjust for medication use, such as anti-depressants, which are commonly prescribed. However, medication can both confound and modify the association between REM sleep and depressive symptoms. In this study we examined whether REM sleep latency, REM sleep duration and REM density are related to depressive symptoms in a population-based sample. We also assessed these associations excluding persons who used sleep medication or medication prescribed for the nervous system. MAT ERIALS AN D METH ODS Study populationThe current study was embedded in the Rotterdam Study, a population-based cohort of middle-aged and elderly inhabitants of Rotterdam, the Netherlands (Hofman et al.,

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“…Rao and Poland [4] studied 16 adolescents with major depressive disorder and 16 volunteers without psychiatric disorder and noted higher nocturnal urine free cortisol among depressed adolescents. This same group performed a prospective trial involving 48 adolescents without psychiatric illness and 48 adolescents with parental history of depression and found that elevated nocturnal urine free cortisol at baseline was associated with development of depression at follow-up [5].…”

Section: Association Of Depressed Mood With Hpa Axis Functionmentioning

confidence: 99%

Biological Basis of Depression in Adults with Diabetes

et al. 2010

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Diabetes and depression are common comorbid conditions. Although certain health behaviors and risk factors partially explain the association of depression and diabetes, other potential mechanisms have yet to be elucidated. Certain neuroendocrine alterations such as activation of the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nervous system (SNS) may contribute to the association. Additionally, presence of a proinflammatory state shown in recent literature in both diabetes and depression may contribute to this as well. The objectives of this review are to summarize and review the recent evidence showing alterations of these three biological systems-HPA axis, SNS, and inflammatory cascade--in depression, diabetes, and diabetes-related risk factors.

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Electroencephalographic Sleep and Hypothalamic–Pituitary–Adrenal Changes from Episode to Recovery in Depressed Adolescents

Abstract: The findings that EEG sleep measures are independent of clinical state, whereas HPA variables are state dependent, suggest that sleep and HPA measures make a differential contribution to our understanding of the pathophysiology and prognosis of mood disorders in adolescent patients.

Cited by 44 publications

References 64 publications

Sleep electroencephalography as a biomarker in depression

Sleep electroencephalography as a biomarker in depression

REM sleep and depressive symptoms in a population‐based study of middle‐aged and elderly persons

Biological Basis of Depression in Adults with Diabetes

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