The Psychophysiology of Sleep in Psychotic Depression: A Longitudinal Study

Abstract

The sleep of a 51-year-old farmer with a severe psychotic depression was studied by electroencephalograph for 31 of 36 hospital days and for 2 nights 3 weeks after discharge. He was successfully treated with 9 sessions of electroconvulsive therapy (ECT); abrupt improvement followed the sixth. Before improvement his sleep was grossly abnormal with much wakefulness. REMP and Stage IV sleep were abnormally low. After successful treatment, REMP showed a compensatory increase. Stage IV sleep increased toward normal very slowly. There were changes in appetite, weight, and bowel function, as well as in mood and behavior.Methought I heard a voice cry "Sleep no more! Macbeth does murder sleep," the innocent sleep,

Electroencephalographic Sleep Recordings and Depression in the Elderly*

“…Only recently, researchers in the biochemical, psychopharmacologic, and psychophysiologic spheres have begun to investigate patients under the age of 20 as well as patients over the age of 60. To date, sleep research in affective disorders has emphasized studies in patients between the ages of 30 and 60 (3,4). In line with this increasing interest in depression in the elderly, we undertook an investigation examining the EEG characteristics of sleep in patients over the age of 60 who were classified under the diagnosis of depression.…”

Serial monitoring of antidepressant response to electroconvulsive therapy with sleep EEG recordings and dexamethasone suppression tests

“…Following a course of ECT, the dream latency increased significantly and the patient became euthymic. The findings of Green and Stajduhar were not confirmed by other authors (Hawkins et al 1967;Zarcone et al 1967;Van de Castle and Hawkins 1969;Mendels et al 1974); these discrepancies are probably secondary to different sleep scoring methods, and more importantly, may be due to the use of REM suppressant medications during the recordings. Our findings with the serial sleep EEG recordings are similar to those reported by Green and Stajduhar 20 years ago.…”

“…The existing reports on the effects of ECT on sleep EEGs all date from 10 to 15 years ago and are difficult to interpret. Nevertheless, all of the studies (Green and Stajduhar 1966;Hawkins et al 1967;Zar~cone et al 1967;Van de Castle and Hawkins 1969;Mendels et al 1974) comment on the beneficial effects of ECT on sleep EEG parameters, particularly those of increased total sleep time, increased stage 4 or delta sleep, increased REM sleep, and decreased number of awakenings. The effects of ECT on REM latency are less clear.…”

Letter to the Editor: The effect of ECT on sleep – A comment to Winkler et al.

“…If we ignore the 4 published single-case reports (Green and Stajduhar, 1966;Grunhaus et al, 1985;Hawkins et al, 1967;Zarcone et al, 1967) (Hoffman et al, 1985), Linkowski et al (N ¼ 6) (Linkowski et al, 1987), Coffey et al (N ¼ 11) (Coffey et al, 1988), Grunhaus et al (N ¼ 10) (Grunhaus et al, 1988), and Lahmeyer et al (N ¼ 6) (Lahmeyer et al, 1989). All of these case series are uniformly consistent in their finding that a course of ECT increases PSG total sleep time and sleep efficiency (Total N ¼ 60).…”