Sleep, gender, and depression: An analysis of gender effects on the electroencephalographic sleep of 302 depressed outpatients

Reynolds, Charles F.; Kupfer, David J.; Thase, Michael E.; Frank, Ellen; Jarrett, David B.; Coble, Patricia A.; Hoch, Carolyn C.; Buysse, Daniel J.; Simons, Anne D.; Houck, Patricia R.

doi:10.1016/0006-3223(90)90454-a

Cited by 95 publications

(38 citation statements)

References 15 publications

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“…Men with MDD had significantly less slowwave sleep and more Stage 1 sleep than in MDD women. These findings are in general agreement with previous research [26,27,29]. It should be noted, however, that there are only a handful of studies on sex differences in sleep in depression.…”

Section: Discussionsupporting

confidence: 82%

“…Although there is compelling evidence that depression pathophysiology is different between men and women [24], the literature regarding sex differences in sleep variables remains equivocal and controversial, with several studies finding few differences between males and females with MDD [26,27], while others report robust EEG differences [28][29][30]. Among those studies detecting sex differences in MDD, the most robust finding is that men with MDD show lower amplitude slow-wave activity (SWA), also known as delta activity in NREM sleep.…”

Section: Introductionmentioning

confidence: 93%

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Sleep Macroarchitecture in Depression: Sex Differences~!2009-11-01~!2010-03-01~!2010-04-21~!

Swanson¹,

Armitage²

2010

TOSLPJ

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Abstract:Background: Although the relationship between sleep and depression has been studied over the past two decades, findings are inconsistent across the literature. The present study evaluated differences in sleep macroarchitecture between adults with major depressive disorder (MDD) and healthy controls, paying particular attention to sex differences.Method: Sleep macroarchitecture was investigated in 129 adults symptomatic with MDD compared to 62 never-depressed healthy controls. Participants were free of psychiatric medications and were required to maintain a set sleep schedule for the 5 days prior to study.Results: Prolonged sleep latency and increased REM density were observed in participants with MDD relative to healthy controls, but REM latency was longer and there were fewer arousals in the MDD group. Regression analysis differentiated between MDD and HC groups, but only in men. Sex differences were also found in the relationship between clinical course of MDD and sleep variables with stronger correlations between sleep, age of onset and MDD severity in men than in women.Conclusions: Sex differences were observed in the relationship between clinical course of depression and sleep and in differentiating patients form healthy controls, supporting a different pathophysiology of depression in men and women.

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Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 93%

Sleep Macroarchitecture in Depression: Sex Differences~!2009-11-01~!2010-03-01~!2010-04-21~!

Swanson¹,

Armitage²

2010

TOSLPJ

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“…Besides these differences related to different drugs, gender also has to be taken into account for the interpretation of sleep-EEG characteristics. Gender differences exist in the sleep EEG of depressed patients under baseline conditions as a higher incidence of EEG delta activity (Reynolds et al, 1990), more delta and beta EEG activity of a higher amplitude, especially in the right hemisphere (Armitage et al, 1995a) or power of the deltaand sigma-frequency range in females (Antonijevic et al, 2000a). A challenge with growth-hormone-releasing hormone (GHRH) led to an increase in sleep efficiency and stage 2 sleep in males, but a decrease in female healthy and depressed subjects (Antonijevic et al, 2000a).…”

Section: Introductionmentioning

confidence: 99%

State Markers of Depression in Sleep EEG: Dependency on Drug and Gender in Patients Treated with Tianeptine or Paroxetine

Murck

Nickel

Künzel

et al. 2003

Neuropsychopharmacol

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Tianeptine enhances while paroxetine inhibits serotonin reuptake into neurons; however, both show an antidepressive action. A subgroup of 38 depressed patients from a drug trial comparing the efficacy of tianeptine with that of paroxetine was studied with regard to their effects on sleep regulation, especially in relation to treatment response. We recorded sleep EEGs at day 7 and day 42 after the start of treatment with either compound, which allows measurement of changes due to the antidepressive medication in relation to the duration of treatment. Spectral analysis of the non-REM sleep EEG revealed a strong decline in the higher sigma frequency range (14-16 Hz) in male treatment responders independent of medication, whereas nonresponders did not show marked changes in this frequency range independent of gender. The patients receiving paroxetine showed less REM sleep and more intermittent wakefulness compared to the patients receiving tianeptine. REM density after 1 week of treatment was a predictor of treatment response in the whole sample. Psychopathological features with regard to the score in single items of the HAMD revealed predictive markers for response, some of which were opposite in the gender groups, especially those related to somatic anxiety. Changes in REM density were inversely correlated to the changes in HAMD in the paroxetine, but not the tianeptine, group. Our data suggest the importance of taking gender into account in the study of the biological effects of drugs. The study further points to the importance of the higher sigma frequency range in the sleep EEG of non-REM sleep and REM density as a marker of treatment response.

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“…Schlafendokrine Veränderungen, wie eine Reduktion der Schlafkontinuität, eine verkürzte REM Latenz, eine erhöhte REM Dichte und eine Verminderung der Tiefschlafdauer sind vielfach bei Patienten mit Major Depression beschrieben worden (Antonijevic et al 2000b;Lauer et al 1991;Reynolds et al 1990;Steiger et al 1989). Männer betreffen.…”

Section: Diskussionunclassified

Geschlechtsspezifische Unterschiede der schlafendokrinen Regulation und deren Bedeutung für die Pathophysiologie der Major Depression

Antonijevic¹

2004

Monographien Aus Dem Gesamtgebiete Der Psychiatrie

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Sleep, gender, and depression: An analysis of gender effects on the electroencephalographic sleep of 302 depressed outpatients

Cited by 95 publications

References 15 publications

Sleep Macroarchitecture in Depression: Sex Differences~!2009-11-01~!2010-03-01~!2010-04-21~!

Sleep Macroarchitecture in Depression: Sex Differences~!2009-11-01~!2010-03-01~!2010-04-21~!

State Markers of Depression in Sleep EEG: Dependency on Drug and Gender in Patients Treated with Tianeptine or Paroxetine

Geschlechtsspezifische Unterschiede der schlafendokrinen Regulation und deren Bedeutung für die Pathophysiologie der Major Depression

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