Am J Psychiatry 1997; 154:870-872
Copyright © 1997 by American Psychiatric Association
Sleep deprivation combined with consecutive sleep phase advance as a fast-acting therapy in depression: an open pilot trial in medicated and unmedicated patients
M Berger, J Vollmann, F Hohagen, A Konig, H Lohner, U Voderholzer and D Riemann
Klinikum der Albert-Ludwigs-Universitat Freiburg, Germany. berger@psylab.ukl.uni-freiburg.de
OBJECTIVE: The authors' goal was to test the hypothesis that the
antidepressant effect of total sleep deprivation can be maintained by
initially avoiding sleep during a supposedly "critical" time period in the
early morning. METHOD: They studied 33 inpatients with major depression,
melancholic type, all of whom responded positively to total sleep
deprivation. Twelve of the patients were men and 21 were women; their mean
age was 46.7 years (SD = 13.7). After total sleep deprivation, the patients
started a sleep schedule from 5:00 p.m. to 12:00 midnight, which then was
shifted back by 1 hour each day until a sleep time of 11:00 p.m. to 6:00
a.m. was reached. RESULTS: Twenty (61%) of the 33 patients who responded to
total sleep deprivation with an improved state of mood maintained this
improvement during sleep phase advance therapy. Drug-free and medicated
patients did not differ from each other. CONCLUSIONS: The rapid
amelioration of mood observed with total sleep deprivation can be preserved
with a succeeding phase shift of the sleep period.
