Targeting Slow Wave Sleep Deficiency in Late-Life Depression: A Case Series With Propofol

Rios, Rachel L.; Kafashan, MohammadMehdi; Hyche, Orlandrea; Lenard, Emily; Lucey, Brendan P.; Lenze, Eric J.; Palanca, Ben Julian A.

doi:10.1016/j.jagp.2023.03.009

Cited by 4 publications

(7 citation statements)

References 59 publications

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“…Instead, there appears to be a dose-dependent response on the change in sleep structure following this paired intervention. The subsequent reduction in N3 sleep and SWA contrast with the effects of subanaesthetic ketamine 51 and propofol, 52 , 53 which both appear to enhance human N3 sleep after i.v. administration.…”

Section: Discussionmentioning

confidence: 85%

Daytime dexmedetomidine sedation with closed-loop acoustic stimulation alters slow wave sleep homeostasis in healthy adults

Smith,

Kafashan,

Rios

et al. 2024

BJA Open

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Section: Discussionmentioning

confidence: 85%

Daytime dexmedetomidine sedation with closed-loop acoustic stimulation alters slow wave sleep homeostasis in healthy adults

Smith,

Kafashan,

Rios

et al. 2024

BJA Open

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“… 116 Secondary analyses rely on the DSR for each night of sleep, which is computed by dividing the average SWA of the first cycle by the average of the second cycle. 97 …”

Section: Discussionmentioning

confidence: 99%

“…Total burst suppression duration for each infusion is quantified from infusion EEG data using a previously described voltage-based algorithm. 97 117 118 …”

Section: Discussionmentioning

confidence: 99%

“…The sample size was determined using pilot study data (two pretreatment and two post-treatment sleep recordings from one participant). 97 We used a mean N3 duration (minutes) of 1.75 (pretreatment) and 10 (post-treatment) and a combined SD of 4.19. For paired measurements within participants, these estimates would only lead to a sample size of 6.…”

Section: Methods and Analysismentioning

confidence: 99%

“…Proof-of-concept was provided by a pilot study in which two participants were treated with two propofol infusions. 97 One patient demonstrated EEG slow waves and minimal burst suppression during infusions. SWS enhancement was noted on postinfusion nights.…”

Section: Introductionmentioning

confidence: 97%

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Propofol enhancement of slow wave sleep to target the nexus of geriatric depression and cognitive dysfunction: protocol for a phase I open label trial

Rios,

Green,

Smith

et al. 2024

BMJ Open

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Introduction Late-life treatment-resistant depression (LL-TRD) is common and increases risk for accelerated ageing and cognitive decline. Impaired sleep is common in LL-TRD and is a risk factor for cognitive decline. Slow wave sleep (SWS) has been implicated in key processes including synaptic plasticity and memory. A deficiency in SWS may be a core component of depression pathophysiology. The anaesthetic propofol can induce electroencephalographic (EEG) slow waves that resemble SWS. Propofol may enhance SWS and oral antidepressant therapy, but relationships are unclear. We hypothesise that propofol infusions will enhance SWS and improve depression in older adults with LL-TRD. This hypothesis has been supported by a recent small case series. Methods and analysis SWIPED (Slow Wave Induction by Propofol to Eliminate Depression) phase I is an ongoing open-label, single-arm trial that assesses the safety and feasibility of using propofol to enhance SWS in older adults with LL-TRD. The study is enrolling 15 English-speaking adults over age 60 with LL-TRD. Participants will receive two propofol infusions 2–6 days apart. Propofol infusions are individually titrated to maximise the expression of EEG slow waves. Preinfusion and postinfusion sleep architecture are evaluated through at-home overnight EEG recordings acquired using a wireless headband equipped with dry electrodes. Sleep EEG recordings are scored manually. Key EEG measures include sleep slow wave activity, SWS duration and delta sleep ratio. Longitudinal changes in depression, suicidality and anhedonia are assessed. Assessments are performed prior to the first infusion and up to 10 weeks after the second infusion. Cognitive ability is assessed at enrolment and approximately 3 weeks after the second infusion. Ethics and dissemination The study was approved by the Washington University Human Research Protection Office. Recruitment began in November 2022. Dissemination plans include presentations at scientific conferences, peer-reviewed publications and mass media. Positive results will lead to a larger phase II randomised placebo-controlled trial. Trial registration number NCT04680910.

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Hypersomnia as a predictor of response to intravenous ketamine/intranasal esketamine in treatment resistant depression

Patarroyo-Rodriguez,

Pazdernik,

Vande Voort

et al. 2024

Journal of Affective Disorders

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Targeting Slow Wave Sleep Deficiency in Late-Life Depression: A Case Series With Propofol

Cited by 4 publications

References 59 publications

Daytime dexmedetomidine sedation with closed-loop acoustic stimulation alters slow wave sleep homeostasis in healthy adults

Daytime dexmedetomidine sedation with closed-loop acoustic stimulation alters slow wave sleep homeostasis in healthy adults

Propofol enhancement of slow wave sleep to target the nexus of geriatric depression and cognitive dysfunction: protocol for a phase I open label trial

Hypersomnia as a predictor of response to intravenous ketamine/intranasal esketamine in treatment resistant depression

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