REM density is associated with treatment response in major depression: Antidepressant pharmacotherapy vs. psychotherapy

Lechinger, Julia; Koch, Jakob; Weinhold, Sara Lena; Seeck‐Hirschner, Mareen; Stingele, Karoline; Kropp-Näf, Cornelia; Braun, M; Drews, Henning Johannes; Aldenhoff, Josef B.; Huchzermeier, Christian; Göder, Robert

doi:10.1016/j.jpsychires.2020.12.009

Cited by 17 publications

(15 citation statements)

References 34 publications

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“…Our study focuses on healthy young adults, but if the findings are confirmed, we believe there are elements of this research that will translate to clinical practice in psychiatry. Increased REM sleep is not beneficial in all circumstances, as evidenced by the high prevalence of disinhibited REM-sleep in mood disorders 10 , 11 , 17 – 22 . Disinhibited REM sleep has been suggested to represent a maladaptive stress response that maintains depressive episodes 10 , 22 , 23 and impacts treatment responses 11 .…”

Section: Discussionmentioning

confidence: 99%

“…Increased REM sleep is not beneficial in all circumstances, as evidenced by the high prevalence of disinhibited REM-sleep in mood disorders 10 , 11 , 17 – 22 . Disinhibited REM sleep has been suggested to represent a maladaptive stress response that maintains depressive episodes 10 , 22 , 23 and impacts treatment responses 11 . However, we did not find an effect of evening BDLE on REM-density.…”

Section: Discussionmentioning

confidence: 99%

“…This “restless” REM-sleep may then increase emotional distress and theoretically be a risk factor for insomnia and mental illness 15 . In the case of depression, increased REM sleep duration in combination with shorter latency to first REM sleep episode and increased REM-density is common, and is understood as a maladaptive disinhibition of REM-sleep that increases vulnerability and impacts treatment responses 10 , 11 , 17 – 23 . Although this research has mostly been undertaken in clinical populations, these characteristics of REM sleep might offer indications whether the increased REM sleep duration is adaptive or dysfunctional.…”

Section: Introductionmentioning

confidence: 99%

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Evening light environments can be designed to consolidate and increase the duration of REM-sleep

Drews

Scott

Engstrøm

et al. 2022

Sci Rep

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Evening exposure to short-wavelength light has disruptive effects on circadian rhythms and sleep. These effects can be mitigated by blocking short-wavelength (blue) frequencies, which has led to the development of evening blue-depleted light environments (BDLEs). We have previously reported that residing 5 days in an evening BDLE, compared with residing in a normal indoor light environment of similar photopic lux, advances circadian rhythms and increases the duration of rapid eye movement (REM) sleep in a randomized cross-over trial with twelve healthy participants. The current study extends these findings by testing whether residing in the evening BDLE affects the consolidation and microstructure of REM sleep in the same sample. Evening BDLE significantly reduces the fragmentation of REM sleep (p = 0.0003), and REM sleep microarousals in (p = 0.0493) without significantly changing REM density or the latency to first REM sleep episode. Moreover, the increased accumulation of REM sleep is not at the expense of NREM stage 3 sleep. BDLE further has a unique effect on REM sleep fragmentation (p = 0.0479) over and above that of circadian rhythms phase-shift, indicating a non-circadian effect of BDLE. If these effects can be replicated in clinical populations, this may have a therapeutic potential in disorders characterized by fragmented REM sleep.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evening light environments can be designed to consolidate and increase the duration of REM-sleep

Drews

Scott

Engstrøm

et al. 2022

Sci Rep

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“…Barbato et al [ 77 ] reported that the propensity to wake from sleep is higher in the REM sleep period with a high density of REM than from the NREM sleep period, possibly reflecting an increased level of the brain arousal process associated with REM sleep. Increased REM density has been reported in depression [ 78 ] and post-traumatic stress disorder [ 79 ], both conditions characterized by hyperarousal. Recent findings have identified “restless REM”, a condition of fragmented REM sleep with a high frequency of eye movements, as an important marker of insomnia [ 80 ]; furthermore, in this patient group, higher REM density together with REM arousal was strongly associated with the slow dissolution of emotional distress.…”

Section: Sleep Quality and Rem Densitymentioning

confidence: 99%

REM Sleep: An Unknown Indicator of Sleep Quality

Barbato

2021

IJERPH

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Standard polysomnographic analysis of sleep has not provided evidence of an objective measure of sleep quality; however, factors such as sleep duration and sleep efficiency are those more consistently associated with the subjective perception of sleep quality. Sleep reduction as currently occurs in our 24/7 society has had a profound impact on sleep quality; the habitual sleep period should fit within what is a limited nighttime window and may not be sufficient to satisfy the whole sleep process; moreover, the use of artificial light during the evening and early night hours can delay and disturb the circadian rhythms, especially affecting REM sleep. The correct phase relationship of the sleep period with the circadian pacemaker is an important factor to guarantee adequate restorative sleep duration and sleep continuity, thus providing the necessary background for a good night’s sleep. Due to the fact that REM sleep is controlled by the circadian clock, it can provide a window-like mechanism that defines the termination of the sleep period when there is still the necessity to complete the sleep process (not only wake-related homeostasis) and to meet the circadian end of sleep timing. An adequate amount of REM sleep appears necessary to guarantee sleep continuity, while periodically activating the brain and preparing it for the return to consciousness.

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“…Sleep research has found REM sleep to be a key factor in central cognitive and health-related functions such as memory consolidation (1), development of major public health challenges as insomnia or depression (2)(3)(4)(5), stress response (6), and even longevity (7). Particularly its close relationship to mental disorders make REM sleep a focus of interest in psychiatry (2,3,5,(8)(9)(10).…”

Section: Introductionmentioning

confidence: 99%

Couple Relationships Are Associated With Increased REM Sleep—A Proof-of-Concept Analysis of a Large Dataset Using Ambulatory Polysomnography

Drews

2021

Front. Psychiatry

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Background/Objectives: Rapid Eye Movement (REM) sleep is associated with memory consolidation and several health effects including stress response, mental health, and longevity. Recently, it has been shown that regularly co-sleeping couples have increased and stabilized REM sleep when co-sleeping as compared to sleeping individually. However, it remained unclear whether this is due to a specific effect of altering the usual sleeping environment by partner deprivation or due to a generalizable REM-sleep promoting effect of couple relationships. The present study aims to clarify this ambiguity.Methods: Married or never married individuals were taken from the Sleep Heart Health Study (n = 5,804) and matched regarding sociodemographic and health parameters. Matching was done using propensity score matching (1:1, nearest neighbor) and resulted in two groups of n = 69 each (married vs. never married). After confirmation of successful matching, samples were compared regarding REM sleep and other polysomnographic parameters (paired Students t-tests or Wilcoxon signed-rank tests).Results: Married individuals showed significantly higher levels of total and relative REM sleep as compared to never married individuals (all p's ≤ 0.003). Neither other sleep stages nor REM-sleep fragmentation differed between groups (all p's ≥ 0.29). Results regarding number of sleep cycles were ambiguous.Conclusion: This is the first between-subjects study to show that couple relationships are associated with increased REM sleep. This finding represents a necessary (but not sufficient) condition for the previously hypothesized self-enhancing feedback loop of REM sleep and sociality as well as for REM-sleep promotion as a mechanism through which couple relationships prevent mental illness.

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REM density is associated with treatment response in major depression: Antidepressant pharmacotherapy vs. psychotherapy

Cited by 17 publications

References 34 publications

Evening light environments can be designed to consolidate and increase the duration of REM-sleep

Evening light environments can be designed to consolidate and increase the duration of REM-sleep

REM Sleep: An Unknown Indicator of Sleep Quality

Couple Relationships Are Associated With Increased REM Sleep—A Proof-of-Concept Analysis of a Large Dataset Using Ambulatory Polysomnography

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