Towards a model of mood responses to sleep deprivation in depressed patients

Bouhuys, Antoinette L.

doi:10.1016/0006-3223(91)90095-4

Cited by 15 publications

(9 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…With the possible exception of the nadir of the cortisol rhythm, there is virtually no evidence that the biological clock in depressed patients is phase advanced relative to the sleep-wake cycle. In other words, the TSD effects are compatible with the assumption of a critical circadian time at which patients are susceptible to the absence or presence of sleep (Bouhuys, 1991). It has been shown in depressed patients that 24-hr tempera-ture rhythms prior to and during TSD, as well as REMS rhythms before and after TSD, did not differ with respect to phase in responders and nonresponders (Beersma et al, 1982;Elsenga et al, 1990a; Van den Hoofdakker et al, 1992).…”

Section: Chronobiological Interpretations Of the Tsd Effectsmentioning

confidence: 65%

Chronobiological Theories of Nonseasonal Affective Disorders and Their Implications for Treatment

Hoofdakker

1994

J Biol Rhythms

View full text Add to dashboard Cite

Downloaded from 158 &dquo;dysrhythmia&dquo; is the consequence of the disruption of external routines, particularly the social routines that would act as zeitgebers for behavioral and mental rhythms, and the sleep-wake cycle; disordered biological rhythms are in this view the result of abnormal masking influences on what are essentially normally regulated endogenous rhythms. The disorder would be comparable with dysregulations underlying shift-work disturbances. The debate represents one variant of the classical debate in psychiatry between those who emphasize endogenous and exogenous causation. The primary source of the illness is either located internally, that is, in &dquo;the clock,&dquo; or in the environment, that is, in &dquo;the social zeitgebers.&dquo; Both concepts can be reconciled. In the first place, disrupted social routines resulting, for example, in changes in sleep timing might entail changes in light exposure, which then in turn would affect the central pacemaker. In such cases the latter would produce a truly abnormal output. Furthermore, pacemakers may have interand intrapersonal variability in the susceptibility to light and alterations of light schedules.Whatever the cause of the &dquo;dysrhythmia&dquo; (i.e., a primary or a secondary abnormality in the circadian regulation), the existence of it is generally accepted, provided that dysrhythmia is taken as a descriptive term covering a broad variety of abnormalities in form, amplitude, and phase positions of all possible kinds of rhythms. In view of the clinical phenomena, such as diurnal variation of mood and early morning awakening, it is understandable that much attention has been paid to the regulation of the sleep-wake cycle. The attention has grown in light of findings that manipulations of this cycle and exposure to bright light induce considerable changes in disturbed mood. These observations constitute the core arguments underlying chronobiological theories of affective disorders. However, the argumentation is precarious. A number of questionable assumptions are tacitly implied. The first is that the various &dquo;dysrhythmias,&dquo; particularly those concerning the sleep-wake cycle, can be interpreted as products of specifiable anomalies in the regulation of this cycle. The second questionable assumption is that if this were true the clinical effects of the manipulation of sleep-wake cycles or exposure to light are the results of their impact on these regulatory anomalies. The third assumption is that , if the former assumption might be valid, this would prove that the affective disorders are caused by these anomalies. Despite its attractiveness, this reasoning is weak. Even if coherent links between some dysregulation and clinical response to manipulations of sleep-wake cycles or exposure to light would be demonstrated, this would not necessarily imply that this link is causal, nor would it show that affective disorders result from this dysregulation. The latter may still be an epiphenomenon.Nevertheless, in view of the wide dispe...

show abstract

Section: Chronobiological Interpretations Of the Tsd Effectsmentioning

confidence: 65%

Chronobiological Theories of Nonseasonal Affective Disorders and Their Implications for Treatment

Hoofdakker

1994

J Biol Rhythms

View full text Add to dashboard Cite

show abstract

“…In order to optimize such treatment and prevent relapse, some authors recommend the association of sleep cycles every night with lithium salts or selective serotonin reuptake inhibitors 51. The antidepressant efficacy of sleep deprivation seems to be influenced by patient characteristics, with a meta-analysis showing that the presence of baseline diurnal variation in mood contributes significantly to prediction of depression levels after total sleep deprivation 52. The therapeutic effect of sleep deprivation is also fully enhanced by the association of this method with light therapy performed in the morning 53…”

Section: Treatment Of Depression By Manipulation Of the Sleep-wake Rhmentioning

confidence: 99%

Sleep disorders and depression: brief review of the literature, case report, and nonpharmacologic interventions for depression

Luca

Luca²,

Calandra

2013

CIA

View full text Add to dashboard Cite

Sleep disorders are so frequently associated with depression that, in the absence of sleep complaints, a diagnosis of depression should be made with caution. Insomnia, in particular, may occur in 60%–80% of depressed patients. Depressive symptoms are important risk factors for insomnia, and depression is considered an important comorbid condition in patients with chronic insomnia of any etiology. In addition, some drugs commonly prescribed for the treatment of depression may worsen insomnia and impair full recovery from the illness. The aim of this paper is to review briefly and discuss the following topics: common sleep disturbances during depression (in particular pavor nocturnus, nightmares, hypersomnia, and insomnia); circadian sleep disturbances; and treatment of depression by manipulation of the sleep-wake rhythm (chronotherapy, light therapy, cycles of sleep, and manipulation of the sleep-wake rhythm itself). Finally, we present a case report of a 65-year-old Caucasian woman suffering from insomnia associated with depression who was successfully treated with sleep deprivation.

show abstract

“…Though overall studies have yielded conflicting results, chronobiological studies in which sleep timing and/or total amount of sleep were re-scheduled in patients provide evidence for the implication of circadian rhythms in depression [46,47]. However, it is still unclear whether these observations represent functional changes of the circadian system itself or are due to the influence of other factors downstream.…”

Section: Depression and Circadian Rhythmsmentioning

confidence: 99%

Chronobiology, excessive daytime sleepiness and depression: Is there a link?

2009

View full text Add to dashboard Cite

The complaint of excessive daytime sleepiness (EDS), commonly encountered in clinical practice, may arise from a variety of psychiatric disorders, most importantly depression. Even though EDS frequently leads depressed patients to seek medical assistance, it is commonly under-evaluated and under-diagnosed. Therefore, a comprehensive understanding and management of EDS is essential in the clinical assessment of depression. Within a theoretical framework, a chronobiological approach may shed new light on the complex interaction of EDS and depression. In this review, studies on EDS and depression are summarized and discussed within the context of circadian and sleep regulatory mechanisms. Furthermore, potential chronobiological therapeutic strategies are proposed to address some of the unmet needs in the treatment of EDS and depression.

show abstract

Towards a model of mood responses to sleep deprivation in depressed patients

Cited by 15 publications

References 24 publications

Chronobiological Theories of Nonseasonal Affective Disorders and Their Implications for Treatment

Chronobiological Theories of Nonseasonal Affective Disorders and Their Implications for Treatment

Sleep disorders and depression: brief review of the literature, case report, and nonpharmacologic interventions for depression

Chronobiology, excessive daytime sleepiness and depression: Is there a link?

Contact Info

Product

Resources

About