Sleep DeprivationTherapy



Sleep deprivation has been used as an alternative, drug-free treatment for depression, producing drastic improvement in mood in about 60% of depressed patients. These improvements typically begin in the morning following a night of sleep deprivation and continue into early afternoon, with relapse occurring when the patient awakens from the following night of sleep or following a nap.  It is evident that the restriction of one or more specific sleep stages may be essential to the therapeutic effects of for example, studies indicate that total sleep deprivation, deprivation in the late part of the night, and REM sleep deprivation appear more effective than any other types of partial deprivation at improving mood in depressed patients. Not only will sleep deprivation improve mood, it will also have beneficial effects on sleep, which is often disturbed in depressed individuals, by improving sleep continuity in terms of the number of awakenings, sleep onset latency, and total sleep time.

       The weakness of sleep deprivation as a treatment for depression is obviously its short duration of action.  Several strategies have been somewhat successful in sustaining the antidepressant effects of sleep deprivation, including increasing the frequency of sleepless nights, and combination with antidepressant drugs such as Prozac.  Additionally, clomipramine and nortriptyline , both tricyclic mixed 5-HT and NE reuptake inhbitors and lithium have been shown to prolong the sleep deprivation induced remission of depressions.  However, further systematic investigations into the benefits of these treatments is required.

    Sleep phase advance is another technique currently being investigated to prolong the antidepressant effects. During this therapy, patients undergo one night of total sleep deprivation.  After this deprivation, the patients start a sleep schedule from 5:00 p.m. -12:00 p.m., which is shifted back one hour every day until the patient eventually sleeps from 11 p.m. to 6:00 a.m. daily.  This therapy has shown to be effective in sustaining mood in up to 60% of depressed patients.

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