Usage of therapeutic sleep deprivation: a survey in psychiatric hospitals in Austria, Germany, and Switzerland
Abstract
Objective: Therapeutic sleep deprivation (SD) is a nonpharmacological treatment that is used most often for depression. The aim of this study was to examine the pattern of use of SD in psychiatric hospitals in Austria, Germany, and Switzerland. Methods: A questionnaire about perceived usage of SD was sent by mail to all 511 psychiatric hospitals in the three countries. Nonresponders were asked to answer the questionnaire by phone. We achieved a response rate of 75.3%. Results: SD was recommended by 61.3% of all hospitals. Despite this degree of recommendation, nearly two thirds of the psychiatric hospitals had not treated a patient with SD during the last 12 months. Of the respondents, 59.5% considered SD to be indicated for major depressive disorder, 17.7% for bipolar depression, and 7.8% for other indications. SD was administered most frequently in inpatient settings and in combination with other therapies. Total SD (patients kept awake entire night) and partial late SD (patients kept awake in second half of night) were judged equally effective. Of the hospitals, 53.0% reported having seen hypomania and 13.2% manic episodes as side effects (rates do not represent actual incident rates). Conclusion: The lack of large controlled studies for SD with its different forms of treatment probably still hinders a broader use of the therapy. Therefore, further efforts should be undertaken to provide high-quality scientific evidence for the usage of SD.
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Despite promising results, the implementation of combined chronotherapy in daily clinical practice remains limited.
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Cites
Trivedi, M. H., Rush, A. J., Wisniewski, S. R., Nierenberg, A. A., Warden, D., Ritz, L., Norquist, G., Howland, R. H., Lebowitz, B., McGrath, P. J., et al. (2006) · American Journal of Psychiatry · doi:10.1176/appi.ajp.163.1.28 · Cited by 3,879 · see citing works
Response Rates and Responsiveness for Surveys, Standards, and the Journal
Fincham, J. E. (2008) · American Journal of Pharmaceutical Education · doi:10.5688/aj720243 · Cited by 1,300 · see citing works
(2017) · Arzneimittelforschung · doi:10.1055/s-00000175 · Cited by 1,134 · see citing works
Wu, J. C., & Bunney, W. E. (1990) · American Journal of Psychiatry · doi:10.1176/ajp.147.1.14 · Cited by 614 · see citing works
Testtheorie und Fragebogenkonstruktion
Moosbrugger, H., & Kelava, A. (2011) · Springer-Lehrbuch · doi:10.1007/978-3-642-20072-4 · Cited by 439 · see citing works
Best Practices for Survey Research Reports: A Synopsis for Authors and Reviewers
Draugalis, J. R., Coons, S. J., & Plaza, C. M. (2008) · American Journal of Pharmaceutical Education · doi:10.5688/aj720111 · Cited by 434 · see citing works
Sleep deprivation in depression: what do we know, where do we go?
Wirz-Justice, A., & Van den Hoofdakker, R. H. (1999) · Biological Psychiatry · doi:10.1016/s0006-3223(99)00125-0 · Cited by 429 · see citing works
Therapeutic use of sleep deprivation in depression
Giedke, H., & Schwärzler, F. (2002) · Sleep Medicine Reviews · doi:10.1053/smrv.2002.0235 · Cited by 294 · see citing works
Chronotherapeutics (light and wake therapy) in affective disorders
WIRZ-JUSTICE, A., BENEDETTI, F., BERGER, M., LAM, R. W., MARTINY, K., TERMAN, M., & WU, J. C. (2005) · Psychological Medicine · doi:10.1017/s003329170500437x · Cited by 291 · see citing works
Self-citationRate of switch from depression into mania after therapeutic sleep deprivation in bipolar depression
Colombo, C., Benedetti, F., Barbini, B., Campori, E., & Smeraldi, E. (1999) · Psychiatry Research · doi:10.1016/s0165-1781(99)00036-0 · Cited by 268 · see citing works
Wu, J. C., Kelsoe, J. R., Schachat, C., Bunney, B. G., DeModena, A., Golshan, S., Gillin, J. C., Potkin, S. G., & Bunney, W. E. (2009) · Biological Psychiatry · doi:10.1016/j.biopsych.2009.02.018 · Cited by 263 · see citing works
Self-citationHimle, J. A., Rassi, S. L., Haghighatgou, H., Krone, K. P., Nesse, R. M., & Abelson, J. L. (2006) · Depression and Anxiety · doi:10.1002/(issn)1520-6394 · Cited by 193 · see citing works
Partial Sleep Deprivation as Therapy for Depression
Tölle, B. S. (1980) · Archives of General Psychiatry · doi:10.1001/archpsyc.1980.01780160037003 · Cited by 170 · see citing works
Pflug, B., & Tölle, R. (2017) · International Pharmacopsychiatry · doi:10.1159/000468269 · Cited by 167 · see citing works
Bright light therapy stabilizes the antidepressant effect of partial sleep deprivation
Neumeister, A., Gößler, R., Lucht, M. J., Kapitany, T., Bamas, C., & Kasper, S. F. (1996) · Biological Psychiatry · doi:10.1016/0006-3223(95)00086-0 · Cited by 158 · see citing works
Is sleep deprivation useful in the treatment of depression?
Leibenluft, E., & Wehr, T. A. (1992) · American Journal of Psychiatry · doi:10.1176/ajp.149.2.159 · Cited by 150 · see citing works
The "Switch Process" in Manic-Depressive Illness
Bunney, W. E. (1972) · Archives of General Psychiatry · doi:10.1001/archpsyc.1972.01750270014002 · Cited by 145 · see citing works
Meta-analysis of the antidepressant effects of acute sleep deprivation
Boland, E. M., Rao, H., Dinges, D. F., Smith, R. V., Goel, N., Detre, J. A., Basner, M., Sheline, Y. I., Thase, M. E., & Gehrman, P. R. (2017) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.16r11332 · Cited by 132 · cited 2× · see citing works
“Total SD and late partial SD have been studied in unipolar, bipolar, and mixed samples (Boland et al., 2017).”
BackgroundKuhs, H., & Tölle, R. (1991) · Biological Psychiatry · doi:10.1016/0006-3223(91)90255-k · Cited by 124 · see citing works
[Therapy of endogenous depressions using sleep deprivation. Practical and theoretical consequences].
Pflug, B., & Tölle, R. (1971) · PubMed · Cited by 122 · see citing works
(1997) · American Journal of Psychiatry · doi:10.1176/ajp.154.6.870 · Cited by 114 · see citing works
Administration of ketamine for unipolar and bipolar depression
Kraus, C., Rabl, U., Vanicek, T., Carlberg, L., Popovic, A., Spies, M., Bartova, L., Gryglewski, G., Papageorgiou, K., Lanzenberger, R., et al. (2017) · International journal of psychiatry in clinical practice · doi:10.1080/13651501.2016.1254802 · Cited by 107 · see citing works
Bosch, O. G., Rihm, J. S., Scheidegger, M., Landolt, H., Stämpfli, P., Brakowski, J., Esposito, F., Rasch, B., & Seifritz, E. (2013) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.1317010110 · Cited by 91 · see citing works
Synaptic plasticity model of therapeutic sleep deprivation in major depression
Wolf, E., Kühn, M., Normann, C., Mainberger, F., Maier, J. G., Maywald, S., Bredl, A., Klöppel, S., Biber, K. P. H., van Calker, D., et al. (2015) · Sleep Medicine Reviews · doi:10.1016/j.smrv.2015.11.003 · Cited by 87 · see citing works
Bright light augments antidepressant effects of medication and wake therapy
Loving, R. T., Kripke, D. F., & Shuchter, S. R. (2002) · Depression and Anxiety · doi:10.1002/da.10036 · Cited by 86 · see citing works
Refractory depression : current strategies and future directions
Nolen, W. A. (1994) · Medical Entomology and Zoology · Cited by 85 · see citing works
Echizenya, M., Suda, H., Takeshima, M., Inomata, Y., & Shimizu, T. (2013) · Journal of Affective Disorders · doi:10.1016/j.jad.2012.06.022 · Cited by 71 · see citing works
Sahlem, G. L., Kalivas, B., Fox, J. B., Lamb, K., Roper, A., Williams, E. N., Williams, N. R., Korte, J. E., Zuschlag, Z. D., El Sabbagh, S., et al. (2014) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2014.08.015 · Cited by 71 · see citing works
Effects of Sleep Deprivation on Daytime Sleepiness in Primary Insomnia
Stepanski, E. J., Zorick, F. J., Roehrs, T., & Roth, T. G. (2000) · SLEEP · doi:10.1093/sleep/23.2.1h · Cited by 59 · see citing works
A clinical trial of sleep deprivation in combination with antidepressant medication
Leibenluft, E., Moul, D. E., Schwartz, P. J., Madden, P. A. F., & Wehr, T. A. (1993) · Psychiatry Research · doi:10.1016/0165-1781(93)90090-4 · Cited by 57 · see citing works
Kasper, S. F., Voll, G., Vieira, A., & Kick, H. A. (1990) · Pharmacopsychiatry · doi:10.1055/s-2007-1014496 · Cited by 55 · see citing works
The timing of partial sleep deprivation in depression
Giedke, H., Geilenkirchen, R., & Hauser, M. (1992) · Journal of Affective Disorders · doi:10.1016/0165-0327(92)90074-g · Cited by 44 · see citing works
Danilenko, K. V., & Putilov, A. A. (2005) · Neuropsychopharmacology · doi:10.1038/sj.npp.1300698 · Cited by 40 · see citing works
Martiny, K., Refsgaard, E., Lund, V., Lunde, M., Thougaard, B., Lindberg, L., & Bech, P. (2015) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12402 · Cited by 37 · see citing works
The effect of sleep deprivation on motor impairment and retinal adaptation in Parkinson's disease
Reist, C., Sokolski, K. N., Chen, C., Coskinas, E., & DeMet, E. M. (1995) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/0278-5846(95)00025-q · Cited by 36 · see citing works
Sleep deprivation response in seasonal affective disorder during a 40-h constant routine
Graw, P. (1998) · Journal of Affective Disorders · doi:10.1016/s0165-0327(97)00142-0 · Cited by 34 · see citing works
Wake and light therapy for moderate-to-severe depression – a randomized controlled trial
Kragh, M., Martiny, K., Videbech, P., Møller, D. N., Wihlborg, C. S., Lindhardt, T., & Larsen, E. R. (2017) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12741 · Cited by 25 · see citing works
Steinberg, H., & Hegerl, U. (2014) · Sleep Medicine · doi:10.1016/j.sleep.2014.03.027 · Cited by 23 · see citing works
[Course of depression after sleep deprivation (author's transl)].
Philipp, M. (1978) · PubMed · Cited by 23 · see citing works
Serial partial sleep deprivation as adjuvant treatment of depressive insomnia
Hemmeter, U., Seifritz, E., Hatzinger, M., Müller, M. J., & Holsboer‐Trachsler, E. (1995) · Progress in Neuro-Psychopharmacology and Biological Psychiatry · doi:10.1016/0278-5846(95)00104-4 · Cited by 19 · see citing works
Therapeutic sleep deprivation and antidepressant medication in patients with major depression
Kasper, S. F., Kick, H. A., Voll, G., & Vieira, A. H. G. (1991) · European Neuropsychopharmacology · doi:10.1016/0924-977x(91)90711-3 · Cited by 18 · see citing works
On the application of light therapy in German-speaking countries
Fischer, R., Kasper, S. F., Pjrek, E., & Winkler, D. (2012) · European Archives of Psychiatry and Clinical Neuroscience · doi:10.1007/s00406-011-0286-3 · Cited by 16 · see citing works
Prediction and prevention of perinatal mental illness
Cantwell, R., & Smith, S. (2006) · Psychiatry · doi:10.1383/psyt.2006.5.1.15 · Cited by 15 · see citing works
[Total and partial sleep deprivation in the treatment of depression: preliminary communication].
Schilgen, B., BISCHOFS, W., Blaszkiewicz, F., Bremer, W., Rudolf, G. A., & Tölle, R. (1976) · PubMed · Cited by 10 · see citing works
Breitstein, J., Penix, B., Roth, B. J., Baxter, T., & Mysliwiec, V. (2014) · Journal of Clinical Sleep Medicine · doi:10.5664/jcsm.3804 · Cited by 8 · see citing works
S3-Leitlinie/Nationale VersorgungsLeitlinie Unipolare Depression - Langfassung, 2. Auflage
Deutsche Gesellschaft Für Psychiatrie, P. U. N. (., & (ÄZQ), Ä. Z. F. Q. I. D. M. (2015) · Ärztliches Zentrum für Qualität in der Medizin · doi:10.6101/azq/000329 · Cited by 8 · see citing works
Use of Light Therapy by Office-Based Physicians
Pjrek, E., Spies, M., Baldinger, P., Perkmann, L., Kasper, S. F., & Winkler, D. (2016) · Neuropsychobiology · doi:10.1159/000477094 · Cited by 7 · see citing works
Motor activity in depressed patients during therapeutic sleep deprivation
Brückner, T., & Wiegand, M. H. (2010) · European Psychiatry · doi:10.1016/j.eurpsy.2009.11.004 · Cited by 4 · see citing works
Flagged first, then by citations
1 of the 49 references couldn’t be matched to a known paper.
Cited by
Sorted by citations
Perspectives in affective disorders: Clocks and sleep
Wirz‐Justice, A., & Benedetti, F. (2019) · European Journal of Neuroscience · doi:10.1111/ejn.14362 · Cited by 108 · see citing works
“Sleep deprivation continues to be used in individual clinics, but interest in further research is lacking (Winkler et al., 2018).”
BackgroundRapid-acting antidepressants and the circadian clock
Sato, S., Bunney, B. G., Mendoza-Viveros, L., Bunney, W. E., Borrelli, E., Sassone‐Corsi, P., & Orozco-Solís, R. (2021) · Neuropsychopharmacology · doi:10.1038/s41386-021-01241-w · Cited by 65 · see citing works
“In Europe SDT is often used as a first line treatment but less frequently in the United States [48].”
BackgroundProspects for circadian treatment of mood disorders
Hühne-Landgraf, A., Welsh, D. K., & Landgraf, D. (2018) · Annals of Medicine · doi:10.1080/07853890.2018.1530449 · Cited by 57 · see citing works
Kohtala, S., Alitalo, O., Rosenholm, M., Rozov, S. V., & Rantamäki, T. (2020) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2020.107741 · Cited by 46 · see citing works
Foo, J. C., Trautmann, N., Sticht, C., Treutlein, J., Frank, J., Streit, F., Witt, S. H., Torre, C. D. L., von Heydendorff, S. C., Sirignano, L., et al. (2019) · Translational Psychiatry · doi:10.1038/s41398-019-0671-7 · Cited by 43 · see citing works
Kordestani-Moghadam, P., Nasehi, M., Vaseghi, S., Khodagholi, F., & Zarrindast, M. (2020) · Physiology and Behavior · doi:10.1016/j.physbeh.2020.113023 · Cited by 24 · see citing works
Manosso, L. M., Duarte, L. A., Martinello, N. S., de Mathia, G. B., & Réus, G. Z. (2023) · CNS & Neurological Disorders - Drug Targets · doi:10.2174/0118715273254093231020052002 · Cited by 23 · see citing works
Ioannou, M., Szabó, Z., Widmark-Jensen, M., Vyrinis, G., Karlsson, C., & Steingrimsson, S. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.705090 · Cited by 13 · see citing works
Lifestyle modification as intervention for seasonal affective disorder: A systematic review
Rothenberg, M., Nußbaumer-Streit, B., Pjrek, E., & Winkler, D. (2024) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2024.03.053 · Cited by 5 · see citing works
Mauracher, L., Serebriakova, J., Niederstätter, H., Parson, W., Schurr, T. A., & Deisenhammer, E. (2024) · The World Journal of Biological Psychiatry · doi:10.1080/15622975.2024.2382697 · Cited by 3 · see citing works
“…effect of sleep deprivation (SD) on depressed patients has been studied for more than 60 years (Wu and Bunney 1990; Boland et al. 2017) and, as chronotherapeutics, is used as an adjunct treatment for affective disorders (Wirz-Justice et al. 2013; Winkler et al. 2019; Ioannou et al. 2021).”
Working with Sleep Difficulties in Bipolar Disorder
Keskinel, D., Mirchandaney, R., & Kaplan, K. A. (2024) · Springer eBooks · doi:10.1007/978-3-031-63349-2_22
Is a new one a well forgotten old? Sleep deprivation as a method of therapy for depression. Part I
Antsyborov, A. V., Dubatova, I. V., & Kalinchuk, A. V. (2021) · Neurology Bulletin · doi:10.17816/nb49755
- Authors
- Winkler, D., Spies, M., Al-Resheg, Y., Wu, J. C., Bunney, W. E., Bunney, B. G., Kasper, S., & Pjrek, E.
- Affiliations
- Medical University of Vienna (AT)
- University of Zurich (CH)
- University of California, Irvine (US)
- Corresponding author
- Winkler, Dietmar
- ORCID
- Venue
- Behavioral Sleep Medicine
- Publisher
- Informa UK Limited
- Published
- 2018-05-18
- Volume
- 17
- Issue
- 6
- Pages
- 713-720
- ISSN
- 1540-2002 (ISSN-L)
- 1540-2010
- OpenAlex
- W2803596194
- Cited by
- 12
- References
- 49
- Citations by year
- 2024: 3 · 2023: 1 · 2021: 3 · 2020: 2 · 2019: 2 · 2018: 1
- FWCI
- 2.62
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Behavioral Sleep Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- major depressive disorder, bipolar depression, psychiatric hospitals, treatment utilization, non-pharmacological treatment, hypomania, manic episodes, adverse effects, inpatient care, Austria, Germany, Switzerland
- MeSH terms
- Adult, Austria, Female, Germany, Hospitals, Psychiatric, Humans, Male, Surveys and Questionnaires, Sleep Deprivation, Switzerland
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