Meta-Analysis of the Antidepressant Effects of Acute Sleep Deprivation

Boland, Elaine M.; Rao, Hengyi; Dinges, David F.; Smith, Ray; Goel, Namni; Detre, John A.; Basner, Mathias; Sheline, Yvette I.; Thase, Michael E.; Gehrman, Philip

doi:10.4088/jcp.16r11332

Cited by 100 publications

(84 citation statements)

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“…In the present cohort the proportion of response to SD was on the higher end of the range reported in a recent meta-analysis, in which response rates ranged from 7-78% (Boland et al, 2017). The authors hypothesized that the small individual sample sizes were likely to contribute to this wide range of response rates.…”

Section: Discussionmentioning

confidence: 44%

“…Therapeutic sleep deprivation (SD) reliably induces rapid and substantial antidepressant effects in the majority of patients with a major depressive episode (Benedetti et al, 2007;Benedetti and Colombo, 2011;Gillin, 1983;Wu and Bunney, 1990). A recent meta-analysis of SD studies showed an average response rate of approximately 50% with significant variability, with up to 78% of patients responding to SD treatment (Boland et al, 2017). Although its therapeutic value is limited due to relapse after recovery sleep (Giedke and Schwärzler, 2002;Wu et al, 1990), SD is particularly unique in its defined immediate positive effect on depressive mood and may therefore offer unique insights about the biological factors underlying depression.…”

Section: Introductionmentioning

confidence: 99%

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Response to Therapeutic Sleep Deprivation: A Naturalistic Study of Clinical and Genetic Factors and Post-Treatment Depressive Symptom Trajectory

Trautmann

Foo

Frank

et al. 2018

Preprint

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Abstract:Research has shown that therapeutic sleep deprivation (SD) has rapid antidepressant effects in the majority of depressed patients. Investigation of factors preceding and accompanying these effects may facilitate the identification of the underlying biological mechanisms. This exploratory study aimed to examine clinical and genetic factors predicting response to SD and determine the impact of SD on illness course. Mood and tiredness during SD were also assessed via visual analogue scales (VAS). Depressed inpatients (n = 78) and healthy controls (n = 15) underwent ~36hrs of SD. Response to SD was defined as a score of ≤ 2 on the Clinical Global Impression Scale for Global Improvement. Depressive symptom trajectories were evaluated for up to a month using self/expert ratings. Impact of genetic burden was calculated using polygenic risk scores for major depressive disorder. 72% of patients responded to SD. Responders and nonresponders did not differ in baseline self/expert depression symptom ratings, but mood subjectively measured by VAS scale differed. Response was associated with lower age (p = 0.007) and later age at life-time disease onset (p = 0.003). Higher genetic burden of depression was observed in non-responders than healthy controls. Up to a month post-SD, depressive symptoms decreased in both patients groups, but more in responders, in whom effects were sustained. The present findings suggest that re-examining SD with a greater focus on biological mechanisms will lead to better understanding of mechanisms of depression.All rights reserved. No reuse allowed without permission.(which was not peer-reviewed) is the author/funder, who has granted bioRxiv a license to display the preprint in perpetuity.

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Section: Discussionmentioning

confidence: 44%

Section: Introductionmentioning

confidence: 99%

Response to Therapeutic Sleep Deprivation: A Naturalistic Study of Clinical and Genetic Factors and Post-Treatment Depressive Symptom Trajectory

Trautmann

Foo

Frank

et al. 2018

Preprint

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“…19 Its effectiveness has also been demonstrated by a meta-analysis. 44 Furthermore, BLT may be performed in combination with SD to enhance and maintain the effect of SD. 35,45 Thus, the combination of different chronotherapies is a viable treatment option.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of bright light therapy for manic and depressive symptoms in patients with bipolar disorder: A systematic review and meta‐analysis

Takeshima

Utsumi

Aoki

et al. 2020

Psychiatry Clin Neurosci

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Aim This systematic review and meta‐analysis evaluated whether bright light therapy (BLT) is an effective and safe treatment for manic/depressive symptoms and a preventive measure for recurrent mood episodes in patients with bipolar disorder. Methods A literature search of major electronic databases was conducted in June 2019, including all published articles up to that date. Two researchers independently selected relevant publications, extracted data, and evaluated methodological quality according to the Cochrane criteria. Results Six randomized controlled trials (RCT) evaluated the efficacy of BLT for bipolar depression. A meta‐analysis found no significant differences between BLT and placebo for the following outcomes: (i) rates of remission from depressive episodes (risk ratio [RR]: 1.81, 95% confidence interval [CI]: 0.43 to 7.64, P = 0.42); (ii) depressive symptom scores (standardized mean difference: −0.25, 95%CI: −0.74 to 0.23, P = 0.30); and (iii) rates of manic switching (RR: 1.00, 95%CI: 0.28 to 3.59, P = 0.26). The sensitivity analysis for studies with low overall indirectness did show a significant antidepressant effect for BLT (RR: 3.09, 95%CI: 1.62 to 5.90, P = 0.006). No RCT investigated the effect of BLT in preventing the recurrence of mood episodes in the euthymic state or in improving manic symptoms in the manic state. No severe adverse events were reported. Conclusion While a meta‐analysis was unable to demonstrate the efficacy of BLT for bipolar depression, a sensitivity analysis did show a significant effect. Further well‐designed studies are needed to clarify the effectiveness of BLT, not only for the depressive state but also for other states, in the treatment of bipolar disorder.

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“…In fact, in the same year that the two-process model was published, Borbely and Wirz-Justice [14] also proposed the S-deficiency hypothesis of depression, which posits that individuals with depression do not build an adequate sleep drive during the course of a normal day of waking. This hypothesis is said to account for several key findings in depression, including sleep disturbances like delayed sleep onset and increased sleep fragmentation, as well as the finding that total sleep deprivation paradoxically alleviates depressive symptoms in 50% of individuals [15–17]. In order to test this hypothesis, several groups have attempted to use more objective measures to examine sleep homeostasis in depression.…”

Section: Models Of Sleep and Swamentioning

confidence: 99%

An Integrated Model of Slow-Wave Activity and Neuroplasticity Impairments in Major Depressive Disorder

Goldschmied

Gehrman

2019

Curr Psychiatry Rep

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Purpose of Review In this review, we aim to integrate the most recent research highlighting alterations in sleep slow-wave activity (SWA), and impairments in neuroplasticity in major depressive disorder (MDD) into a novel model of disorder maintenance. Recent Findings Sleep homeostasis has been shown to be impaired in MDD, with a subset of individuals also demonstrating impaired SWA. SWA is considered a marker of the homeostatic regulation of sleep, and is implicated in the downscaling of synaptic strength in the context of maintaining homeostatic plasticity. Individuals with MDD have been shown to exhibit impairments in both neural plasticity such as loss of dendritic branching, and synaptic plasticity such as decreased long-term potentiation-dependent learning and memory. Summary Alterations in the homeostatic regulation of sleep, SWA, and synaptic plasticity in MDD suggest an underlying impairment in the modulation of synaptic strength. One candidate mechanism for this impairment is AMPA receptor trafficking.

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Meta-Analysis of the Antidepressant Effects of Acute Sleep Deprivation

Cited by 100 publications

References 0 publications

Response to Therapeutic Sleep Deprivation: A Naturalistic Study of Clinical and Genetic Factors and Post-Treatment Depressive Symptom Trajectory

Response to Therapeutic Sleep Deprivation: A Naturalistic Study of Clinical and Genetic Factors and Post-Treatment Depressive Symptom Trajectory

Efficacy and safety of bright light therapy for manic and depressive symptoms in patients with bipolar disorder: A systematic review and meta‐analysis

An Integrated Model of Slow-Wave Activity and Neuroplasticity Impairments in Major Depressive Disorder

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