Cited by 429Sleep and related disordersCircadian rhythm and melatoninSleep and Wakefulness Research

Sleep deprivation in depression: what do we know, where do we go?

Wirz-Justice, Anna, Van den Hoofdakker, Rutger H·1999·Biological Psychiatry

Abstract

Manipulations of the sleep-wake cycle, whether of duration (total or partial sleep deprivation [SD]) or timing (partial SD, phase advance), have profound and rapid effects on depressed mood in 60% of all diagnostic subgroups of affective disorders. Relapse after recovery sleep is less when patients are receiving medication; it may be prevented by co-administration of lithium, pindolol, serotonergic antidepressants, bright light, or a subsequent phase advance procedure. Diurnal and day-to-day mood variability predict both short-term response to SD and long-term response to antidepressant drug treatment. These mood patterns can be understood in terms of a "two-process model of mood regulation" based on the model well established for sleep regulation: the interaction of circadian and homeostatic processes. The therapeutic effect of SD is postulated to be linked to changes in disturbed circadian- and sleep-wake-dependent phase relationships and concomitant increase of slow-wave-sleep pressure; additionally, SD-induced sleepiness may counteract the hyperarousal state in depression. This model has the advantage of providing a comprehensive theoretical framework and stringent protocols ("constant routine," "forced desynchrony") to dissect out specific disturbances. Many aspects tie in with current serotonergic receptor hypotheses of SD action. A treatment inducing euthymia in severely depressed patients within hours is an important therapeutic option that has come of age for clinical use.

Integrity signals

Registry

Crossref · 10.1016/s0006-3223(99)00125-0

Cites

66 of 66 references verified0 citation errors · 0 not checkable

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  • Antidepressant medications typically require 2 to 8 weeks to have an effect.

    “in contrast to antidepressant medications that typically require 2 to 8 weeks to have an effect.52,53”

    From Sleep Deprivation and Circadian Disruption (2015) · cites this paper as [53]

  • Acute sleep deprivation is effective in 40% to 60% of depressed subjects in improving mood within 24 to 48 hours.

    “Moreover, acute sleep deprivation is effective in 40% to 60% of depressed subjects in improving mood within 24 to 48 hours, in contrast to antidepressant medications that typically require 2 to 8 weeks to have an effect.52,53”

    From Sleep Deprivation and Circadian Disruption (2015) · cites this paper as [53]

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Authors
Wirz-Justice, A., & Van den Hoofdakker, R. H.
Venue
Biological Psychiatry
Publisher
Elsevier BV
Published
1999-08
Volume
46
Issue
4
Pages
445-453
ISSN
0006-3223 (ISSN-L)
OpenAlex
W2076299279
Cited by
429
References
66
Citations by year
2025: 8 · 2024: 8 · 2023: 8 · 2022: 8 · 2021: 11 · 2020: 13 · 2019: 15 · 2018: 11 · 2017: 12 · 2016: 14 · 2015: 18 · 2014: 24 · 2013: 33 · 2012: 9
FWCI
6.83
Type
journal article
Language
en
Open access
closed
Locations
  • Biological Psychiatry (publishedVersion)
  • PubMed (publishedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (publishedVersion)
  • University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
  • Life Sciences › Neuroscience › Cognitive Neuroscience › Sleep and Wakefulness Research
Keywords
sleep deprivation, depression, circadian rhythm, phase advance, slow-wave sleep, hyperarousal, mood variability, antidepressant response, lithium, pindolol, serotonergic antidepressants, bright light therapy, forced desynchrony, constant routine, sleep-wake cycle
MeSH terms
Antidepressive Agents, Brain Chemistry, Circadian Rhythm, Combined Modality Therapy, Depression, Humans, Models, Neurological, Sleep Deprivation, Sleep Stages, Mood Disorders

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