Am J Psychiatry 1995; 152:404-412
Copyright © 1995 by American Psychiatric Association
Early versus late partial sleep deprivation in patients with premenstrual dysphoric disorder and normal comparison subjects
BL Parry, H Cover, N Mostofi, B LeVeau, PA Sependa, A Resnick and JC Gillin
Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla 92093-0804.
OBJECTIVE: The aim of this study was to compare the clinical effects of
early-night and late-night partial sleep deprivation in patients with
premenstrual dysphoric disorder and normal comparison subjects. METHOD: In
the premenstrual phase of two menstrual cycles, 23 subjects with DSM- IV
premenstrual dysphoric disorder and 18 normal comparison subjects underwent
a randomized crossover trial of 1) early-night sleep deprivation, in which
subjects slept from 3:00 a.m. to 7:00 a.m., followed by a night of recovery
sleep (11:00 p.m. to 7:00 a.m.), and 2) late-night sleep deprivation, in
which subjects slept from 9:00 p.m. to 1:00 a.m., followed by a night of
recovery sleep. RESULTS: For the subjects with premenstrual dysphoric
disorder, in both partial sleep deprivation conditions the Hamilton and
Beck depression ratings were significantly lower after recovery sleep than
at baseline. Ratings on the day after early or late partial sleep
deprivation tended to be lower than at baseline but were not statistically
different. The normal comparison subjects showed no clinically important
mood changes. A factor analytic approach used with the Hamilton depression
scores showed that depressive retardation symptoms were the most responsive
to sleep deprivation in the premenstrual dysphoric disorder subjects.
CONCLUSIONS: These results are consistent with the reported efficacy of
sleep deprivation for major depressive disorder. However, the premenstrual
dysphoric disorder subjects improved after the recovery sleep rather than
directly after partial sleep deprivation. That late- night sleep
deprivation did not have greater benefit than did the hypothesized sham
treatment, early-night sleep deprivation, also suggests that placebo
effects cannot be ruled out.
