Extended sleep (hypersomnia) in young depressed patients

Abstract

To test the hypothesis that young depressed patients have prolonged rather than shortened sleep, 14 depressed patients aged 17-25 and age-matched normal control subjects were allowed to sleep as long as they wanted. All subjects increased their sleep over baseline values, but the extended sleep period of the depressed patients was almost twice as long as that of the control subjects. The distribution of sleep stages in the extended period did not differ. The depressed patients had changes in the length of REM periods similar to those of older subjects. The findings suggest an interaction between age, sleep, and depression.

Objective measures of sleep duration and continuity in major depressive disorder with comorbid hypersomnolence: a primary investigation with contiguous systematic review and meta‐analysis

“…The vast majority of clinical and research polysomnograms are not performed allowing the patient to go to bed and wake on their own accord, most likely due to logistical difficulties encountered when patients sleep well into the day. However, as demonstrated by these results and by prior studies, extended polysomnographic recordings are likely invaluable in quantifying hypersomnolence, particularly when it is comorbid with a mood disorder (Hawkins et al ., 1985). In addition, our actigraphic measures substantiate that increased sleep duration in participants with depression and comorbid hypersomnolence relative to controls can also be documented outside of the sleep laboratory, and that results of polysomnography were not likely due to sleep deprivation prior to in-laboratory assessment.…”

“…Reasons full-text articles were excluded are detailed in Figure 2. Seven studies (in addition to the current study) were identified via systematic review for inclusion in meta-analyses (Dolenc et al ., 1996; Hawkins et al ., 1985; Hiyama, 1982; Plante et al ., 2012; Quitkin et al ., 1985; Thase et al ., 1989; Vgontzas et al ., 2000) (Table 5). Three of these studies had reports of ad libitum total sleep time, while seven either reported sleep efficiency or provided sufficient data to derive this variable.…”

“…Moreover, had patients with narcolepsy inadvertently been included, this would have likely biased our results towards reductions in sleep efficiency relative to controls, given sleep fragmentation observed in both type 1 and 2 narcolepsy (Baumann et al ., 2014, Roth et al ., 2013), and thus our results are unlikely to have been substantially affected by this issue. Second, our ad libitum polysomnographic protocol occurred after a naturalistic observation period outside of the laboratory, but did not include repeated in-laboratory nights as utilized in some other investigations (Dolenc et al ., 1996; Hawkins et al ., 1985; Vernet and Arnulf, 2009), which may limit comparability between studies. However, our protocol had the advantage of more closely mirroring clinical practice and thus the generalizability of findings.…”

The Neurobiological Mechanisms and Treatments of REM Sleep Disturbances in Depression

“…Currently, depression is a common disease and has become increasingly prevalent in the world [ 1 ]. Most depressed people show evidence of one or more changes in sleep neurophysiology; i.e., some complain of insomnia and the others suffer from hypersomnia [ 2 , 3 ]; therefore, impaired sleep is a critical symptom of depressed patients. Gresham SC et al .…”

Sleep disturbances in pediatric depression

“…While delayed sleep-onset and frequent awakenings accompany almost any kind of insomnia, early morning awakening was considered to be specific for endogenous depression but this hypothesis was not confirmed (Reynolds and Kupfer, 1987). Although insomnia is the most frequent complaint, hypersomnia also has been observed (Garvey et al, 1984; Hawkins et al, 1985), particularly in individuals with bipolar depression (Parker et al, 2006; Thase et al, 1989). …”