The DOI matches its Crossref record; 224 of the 230 references it cites were found in a registry or an index.
REM sleep dysregulation in depression: State of the art
Abstract
Disturbances of sleep are typical for most depressed patients and belong to the core symptoms of the disorder. Since the 1960s polysomnographic sleep research has demonstrated that besides disturbances of sleep continuity, depression is associated with altered sleep architecture, i.e., a decrease in slow wave sleep (SWS) production and disturbed rapid eye movement (REM) sleep regulation. Shortened REM latency (i.e., the interval between sleep onset and the occurrence of the first REM period), increased REM sleep duration and increased REM density (i.e., the frequency of rapid eye movements per REM period) have been considered as biological markers of depression which might predict relapse and recurrence. High risk studies including healthy relatives of patients with depression demonstrate that REM sleep alterations may precede the clinical expression of depression and may thus be useful in identifying subjects at high risk for the illness. Several models have been developed to explain REM sleep abnormalities in depression, like the cholinergic-aminergic imbalance model or chronobiologically inspired theories, which are reviewed in this overview. Moreover, REM sleep alterations have been recently considered not only as biological "scars" but as true endophenotypes of depression. This review discusses the genetic, neurochemical and neurobiological factors that have been implicated to play a role in the complex relationships between REM sleep and depression. We hypothesize on the one hand that REM sleep dysregulation in depression may be linked to a genetic predisposition/vulnerability to develop the illness; on the other hand it is conceivable that REM sleep disinhibition in itself is a part of a maladaptive stress reaction with increased allostatic load. We also discuss whether the REM sleep changes in depression may contribute themselves to the development of central symptoms of depression such as cognitive distortions including negative self-esteem and the overnight consolidation of negatively toned emotional memories.
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In the citing paper
“Actually, the role of REM sleep in the mood regulation is somehow controversial since several studies found that this stage has a depressant effect (Palagini et al., 2013).”
From The Functional Role of Dreaming in Emotional Processes (2019) · cites this paper as Palagini et al., 2013
In the citing paper
“Depressed subjects also show reductions in slow wave (stage 3/4) sleep, increases in rapid eye movement (REM) sleep, including a shorter latency to REM initiation, a protraction of the REM sleep period, and increases in REM density (Palagini et al., 2013; Riemann et al., 2001; Tsuno et al., 2005).”
From The role of inflammation in core features of depression: Insights from paradigms using exogenously-induced inflammation. (2018) · cites this paper as Palagini et al., 2013
In the citing paper
“Depressed subjects also show reductions in slow wave (stage 3/4) sleep, increases in rapid eye movement (REM) sleep, including a shorter latency to REM initiation, a protraction of the REM sleep period, and increases in REM density (Palagini et al., 2013; Riemann et al., 2001; Tsuno et al., 2005).”
From The role of inflammation in core features of depression: Insights from paradigms using exogenously-induced inflammation. (2018) · cites this paper as Palagini et al., 2013
In the citing paper
“Depressed subjects also show reductions in slow wave (stage 3/4) sleep, increases in rapid eye movement (REM) sleep, including a shorter latency to REM initiation, a protraction of the REM sleep period, and increases in REM density (Palagini et al., 2013; Riemann et al., 2001; Tsuno et al., 2005).”
From The role of inflammation in core features of depression: Insights from paradigms using exogenously-induced inflammation. (2018) · cites this paper as Palagini et al., 2013
In the citing paper
“Depressed subjects also show reductions in slow wave (stage 3/4) sleep, increases in rapid eye movement (REM) sleep, including a shorter latency to REM initiation, a protraction of the REM sleep period, and increases in REM density (Palagini et al., 2013; Riemann et al., 2001; Tsuno et al., 2005).”
From The role of inflammation in core features of depression: Insights from paradigms using exogenously-induced inflammation. (2018) · cites this paper as Palagini et al., 2013
In the citing paper
“Depressed subjects also show reductions in slow wave (stage 3/4) sleep, increases in rapid eye movement (REM) sleep, including a shorter latency to REM initiation, a protraction of the REM sleep period, and increases in REM density (Palagini et al., 2013; Riemann et al., 2001; Tsuno et al., 2005).”
From The role of inflammation in core features of depression: Insights from paradigms using exogenously-induced inflammation. (2018) · cites this paper as Palagini et al., 2013
In the citing paper
“However, exogenously-induced inflammation using both endotoxin and IFN-α also led to a suppression of REM sleep (Mullington et al., 2000; Raison et al., 2010), which is the opposite of changes observed in depressed patients (Palagini et al., 2013; Riemann et al., 2001; Tsuno et al., 2005).”
From The role of inflammation in core features of depression: Insights from paradigms using exogenously-induced inflammation. (2018) · cites this paper as Palagini et al., 2013
In the citing paper
“and remediate one of the sleep problems influenced by inflammation (Palagini et al., 2013; Riemann et al., 2001)”
From The role of inflammation in core features of depression: Insights from paradigms using exogenously-induced inflammation. (2018) · cites this paper as Palagini et al., 2013
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“depression [46], excessive sleepiness [47]), which is not representative of the current population of junior athletes.”
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Volitional limbic neuromodulation exerts a beneficial clinical effect on Fibromyalgia
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“Of the numerous manifestations of aberrant sleep in Fi-bromyalgia, our focus was on REM latency, which is known to be related to amygdala activation (Luppi et al., 2004; Nofzinger et al., 2004) and affective dysregulation in mood disorders (Kupfer, 1976; Palagini et al., 2013).”
Developmental changes in sleep and their relationships to psychiatric illnesses
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Sleep Disturbances and Depression in the Multi-Ethnic Study of Atherosclerosis
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“Cartwright (2010, Ch. 4; see also Nutt et al., 2008; Palagini et al., 2013) describes how severe depression often involves a premature transition from early light sleep to a disordered form of REM.”
BackgroundKo, C., Fan, J., Hu, A., Su, H., Yang, J., Huang, L., Yan, F., Zhang, H., & Zeng, Y. (2019) · Brain and Behavior · doi:10.1002/brb3.1287 · Cited by 52
“Additionally, the gut microbiota alterations manifested in IH and SF mimic in OSAHS animal models (Moreno‐Indias et al., 2015; Poroyko et al., 2016).”
BackgroundResultInfluentialHoyos, C. M., Gordon, C. J., Terpening, Z., Norrie, L. M., Lewis, S. J. G., Hickie, I. B., & Naismith, S. L. (2020) · BMC Psychiatry · doi:10.1186/s12888-020-02606-z · Cited by 53
Sleep in adolescent depression: physiological perspectives
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“The exact mechanisms by which increased amount and intensity of REM sleep and depression are linked are not fully understood, but various theories and models have been proposed (for a recent thorough review see Palagini et al. 2013).”
BackgroundInfluentialShariq, A. S., Rosenblat, J. D., Alageel, A. A. S., Mansur, R. B., Rong, C., Ho, R., Ragguett, R., Pan, Z., Brietzke, E. M., & McIntyre, R. S. (2018) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/j.pnpbp.2018.12.008 · Cited by 51
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“It is also possible that the REM interaction effect is highly sensitive to loss of severe PTSD cases, as may have been the case in this sample, and our previous research indicates strongly that comorbid MDD is more common as CAPS scores increase.”
BackgroundInfluentialPolysomnography in seasonal affective disorder: A systematic review and meta-analysis
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“On the other hand, previous studies have tried to use the latency as a REM sleep parameter to predict depression occurrence and have found that this parameter is not reliable [66–68].”
Multi-Level Processes and Retina–Brain Pathways of Photic Regulation of Mood
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“It is thus hypothesized that this misalignment between circadian rhythms and the light–dark cycle would lead to depressive symptoms and so would explain both the early awakening and the shortening of the rapid eye movement (REM) sleep latency, two circadian markers frequently found altered in depressive disorders [71].”
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Poor sleep quality in systemic lupus erythematosus: does it depend on depressive symptoms?
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Self-citationNightmares and nonsuicidal self-injury: The mediating role of emotional dysregulation
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Selective activation of serotoninergic dorsal raphe neurons facilitates sleep through anxiolysis
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“To this end, SSRIs are a frequently employed and highly effective treatment for anxiety and depression in humans, but they also influence sleep, specifically REM sleep [52].”
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“For example, individuals suffering from major depressive disorder (MDD) and bipolar disorder (BD) show significant sleep and circadian rhythm disturbances during mood episodes (Gonzalez 2014; Harvey 2011; McClung 2013; Palagini et al. 2013; WirzJustice 2006).”
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“Moreover, increased REM density associated with depressive symptoms changes sleep structure and may interfere with sleep quality (Palagini et al. 2013).”
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Melanin-concentrating hormone (MCH) modulates the activity of dorsal raphe neurons
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Segalàs, C., Labad, J., Salvat‐Pujol, N., Real, E., Alonso, P., Bertolín, S., Jiménez‐Múrcia, S., Soriano‐Mas, C., Monasterio, C., Menchón, J. M., et al. (2021) · BMC Psychiatry · doi:10.1186/s12888-021-03038-z · Cited by 42
The association between emotional dysregulation and REM sleep features in insomnia disorder
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Sleep, Sleep Disorders, and Mental Health: A Narrative Review
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“[14] Reduced SWS has also been associated with insomnia, [15] mood, and anxiety disorders, [16] generalized alterations of SWS are present in psychosis and neurodevelopmental conditions, [17] and anxiety.”
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“It has been described that depression is associated with disrupted REM sleep—shortened REM latency increased REM duration, and increased REM density [140].”
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“…a, b, *, Keith Wafford a, Elaine Shanks a, Marcin Ligocki a, Dale M. Edgar a, Derk-Jan Dijk b a Lilly Research Laboratories, Windlesham, Surrey, GU20 6PH, UK b Surrey Sleep Research Centre, Faculty of Health and Medical Sciences, University of Surrey, Guilford,…”
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“The optimism-depressive mood-sleep quality link was conceptualized as optimists adopting active coping strategies, maintaining better health, and being more hopeful, resulting in depressive mood (Chang et al., 2013; Karlsson et al., 2011), and in turn better sleep quality (Palagini et al., 2013).”
BackgroundSex differences in sleep, anhedonia, and HPA axis activity in a rat model of chronic social defeat
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“HPA axis dysregulation and the accompanying hyperarousal impacts sleep architecture evidenced by impaired sleep continuity, reductions in NREMS, and disinhibition of REMS (Palagini et al., 2013; Pillai et al., 2011).”
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“It is known that depression is associated with disturbed sleep and alternation in REM-Sleep [8].”
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“This is 2 unsurprising, considering that sleep disturbances are reported by up to 90 % of MDD 3 patients (Baglioni et al., 2011; Palagini et al., 2013), however, these between-group 4 differences in sleep quality may have also influenced emotional memory processing 5 (Tempesta, De Gennaro, Natale,…”
Metadata
- Authors
- Palagini, L., Baglioni, C., Ciapparelli, A., Gemignani, A., & Riemann, D.
- Affiliations
- University of Pisa (IT)
- University of Freiburg (DE)
- Corresponding author
- Palagini, Laura
- Venue
- Sleep Medicine Reviews
- Publisher
- Elsevier BV
- Published
- 2013-10
- Volume
- 17
- Issue
- 5
- Pages
- 377-390
- ISSN
- 1087-0792 (ISSN-L)
- OpenAlex
- W2022024201
- Cited by
- 513
- References
- 230
- Citations by year
- 2026: 53 · 2025: 59 · 2024: 42 · 2023: 61 · 2022: 35 · 2021: 45 · 2020: 31 · 2019: 38 · 2018: 35 · 2017: 24 · 2016: 31 · 2015: 30 · 2014: 18 · 2013: 10
- FWCI
- 2.52
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Sleep Medicine Reviews (publishedVersion)
- PubMed (publishedVersion)
- CINECA IRIS Institutial research information system (University of Pisa) (submittedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion)
- Institutional Research Information System University of Ferrara (University of Ferrara) (submittedVersion)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Pharmacology (medical) › Treatment of Major Depression
- Keywords
- REM sleep, depression, REM latency, REM density, REM sleep duration, sleep architecture, slow-wave sleep, depression biomarkers, endophenotypes, chronobiology, genetic susceptibility, allostatic load, maladaptive stress response, emotional memory consolidation, cognitive distortions, recurrence prediction
- MeSH terms
- Antidepressive Agents, Brain, Depression, Humans, Sleep Deprivation, Sleep Wake Disorders, Sleep, REM, Stress, Psychological
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