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Cited by 99Sleep and related disordersTreatment of Major DepressionCircadian rhythm and melatonin

How to preserve the antidepressive effect of sleep deprivation: a comparison of sleep phase advance and sleep phase delay

Riemann, D., König, A., Hohagen, F., Kiemen, A., Voderholzer, U., Backhaus, J., Bunz, J., Wesiack, B. +2 more·1999·European Archives of Psychiatry and Clinical Neuroscience
DOI 10.1007/s004060050092
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Abstract

Total sleep deprivation (TSD) leads to an immediate amelioration of depressed mood in approximately 70 % of patients with the melancholic subtype of depression. The clinical utility of this procedure is limited, as the improvement usually subsides after the next night of sleep. In the present study, 40 depressed inpatients, being free of psychoactive medication for at least 7 days and who had responded to a TSD were then distributed (according to a matched-pair design) to a sleep phase advance (SPA = time in bed scheduled from 1700-2400 hrs) or a sleep phase delay (SPD = time in bed from 0200-0700 hrs) with a succeeding shift back (for one hour in the SPA group per day) respectively shift forward (for 30 minutes in the SPD group per day), until the initial sleep phase (2300-0600 hrs) was reached after seven days again. Based on previous observations it was hypothesized that a phase advance of the sleep period should prevent responders to TSD from relapsing. Whereas 75% of the TSD responders were stabilized by the phase advanced condition and did not relapse over a period of seven days, only 40% of the patients in the phase delayed condition did not relapse. Polysomnography during the course of the study gave no evidence that the unusual sleep schedules caused prolonged sleep deprivation. Abnormalities of REM sleep persisted both in the clinical responders and non-responders after the sleep wake manipulation. It is concluded that the clinical effectiveness of TSD can be significantly improved by combining TSD with a following phase advance of the sleep period.

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  • Follow-up treatment with daily light therapy or a short phase advance in the sleep/wake cycle can prevent relapse after total sleep deprivation.

    “Furthermore, follow up treatment with daily light therapy or a short phase advance in the sleep/wake cycle can also prevent relapse (Berger et al., 1997; Riemann et al., 1999; Wirz-Justice et al., 2005).”

    From Circadian genes, rhythms and the biology of mood disorders (2007) · cites this paper as Riemann et al., 1999

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Authors
Riemann, D., König, A., Hohagen, F., Kiemen, A., Voderholzer, U., Backhaus, J., Bunz, J., Wesiack, B., Hermle, L., & Berger, M.
Affiliations
University Medical Center Freiburg (DE)
ORCID
Venue
European Archives of Psychiatry and Clinical Neuroscience
Publisher
Springer Science and Business Media LLC
Published
1999-11-05
Volume
249
Issue
5
Pages
231-237
ISSN
  • 0003-9373 (ISSN-L)
  • 0940-1334
  • 1433-8491
DOI
10.1007/s004060050092
OpenAlex
W2010387473
Cited by
99
References
19
Citations by year
2026: 3 · 2023: 1 · 2022: 5 · 2021: 1 · 2020: 6 · 2019: 3 · 2018: 2 · 2017: 2 · 2016: 2 · 2015: 2 · 2014: 2 · 2013: 5 · 2012: 4
FWCI
14.34
Type
journal article
Language
en
Open access
closed
Licence
www.springer.com/tdm (tdm)
Locations
  • European Archives of Psychiatry and Clinical Neuroscience (publishedVersion)
  • PubMed (publishedVersion)
  • FreiDok plus (Universitätsbibliothek Freiburg) (submittedVersion)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
Keywords
total sleep deprivation, sleep phase advance, endogenous depression, antidepressant effects, relapse prevention, REM sleep abnormalities, circadian rhythm, inpatient depression treatment
MeSH terms
Adult, Analysis of Variance, Bipolar Disorder, Circadian Rhythm, Depressive Disorder, Female, Humans, Male, Middle Aged, Recurrence, Sleep Deprivation, Sleep Stages, Sleep, REM, Treatment Outcome, Polysomnography

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