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Cited by 43Treatment of Major DepressionSleep and related disordersCircadian rhythm and melatonin

The day-to-day acute effect of wake therapy in patients with major depression using the HAM-D6 as primary outcome measure: results from a randomised controlled trial

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Martiny, Klaus, Refsgaard, Else, Lund, Vibeke, Lunde, Marianne, Sørensen, Lene, Thougaard, Britta, Lindberg, Lone, Bech, Per·2013·PLoS ONE
DOI 10.1371/journal.pone.0067264PMC PMC3696105
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Abstract

BACKGROUND: This paper reports day-to-day data for from a one-week intervention phase, part of a 9-weeks randomised parallel study with patient having major depression (data from weekly visits have been reported). Wake therapy (sleep deprivation) has an established antidepressant effect with onset of action within hours. Deterioration on the following night's sleep is, however, common, and we used daily light therapy and sleep time stabilisation as a preventive measure. In particular, we evaluated the day-to-day acute effect of and tolerance to sleep deprivation and examined predictors of response. METHODS: Patients were assessed at psychiatric inpatient wards. In the wake group (n = 36), patients did three wake therapies in combination with light therapy each morning together with sleep time stabilisation. In the exercise group (n = 38), patients did daily exercise. Hamilton subscale scores were primary outcome (not blinded), secondary outcome was self-assessment data from the Preskorn scale and sleep. RESULTS: Patients in the wake therapy group had an immediate, large, stable, and statistically significant better antidepressant effect than patients in the exercise group with response rates at day5 of 75.0%/25.1% and remission rates of 58.6%/6.0%, respectively. The response and remission rates were diminished at day8 with response rates of 41.9%/10.1% and remission rates of 19.4%/4.7%, respectively. Patients and ward personnel found the method applicable with few side effects. Positive diurnal variation (mood better in the evening) predicted a larger response to wake therapy. In the wake group napping on days after intervention predicted greater deterioration on day8. CONCLUSIONS: The intervention induced an acute antidepressant response without relapse between wake nights but with a diminishing effect after intervention. Development is still needed to secure maintenance of response. Avoiding napping in the days after wake therapy is important. TRIAL REGISTRATION: Clinical trials.gov NCT00149110.

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  • Other control conditions such as low-intensity exercise and mild sleep/light management have been previously used.

    “other control conditions such as low-intensity exercise and mild sleep/light management has been previously used (39, 40, 49).”

    From Total Sleep Deprivation Followed by Bright Light Therapy as Rapid Relief for Depression: A Pragmatic Randomized Controlled Trial (2021) · cites this paper as [40]

    Methods > General describes exercise as the comparison condition, supporting the claim that an exercise control has been used. But Results > General calls its mean intensity moderate, not low, and Methods > General places light therapy and sleep-timing control in the active wake-therapy group, not a mild sleep/light control condition. The indexed passages provide no page numbers. (LLM, conf=0.88)

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Research works printed but not linked: 4

  1. H Kuhs, 1991, Sleep deprivation therapy, Biol Psychiatry, 29, 1129, 10.1016/0006-3223(91)90255-K · DOI
  2. Bech P, Licht RW, Stage KB, Abildgaard W, Bech-Andersen G, et al.. (2005) In “Kompendium, Rating scales for Affektive Lidelser”, Psychiatric Research Unit, Mental Health Centre North Zealand, University Hospital of Copenhagen, Denmark 2<sup>nd</sup> edition.
  3. Terman M, Terman JS (2010) Light Therapy. In: Principles and Practice of Sleep Medicine, 5<sup>th</sup> edition. Edited by Kryger MH, Roth T, Dement WC. St. Louis: Elsevier/Saunders 1682–1695.
  4. Hedges LV, Olkin I (1985) Statistical methods for meta-analysis. New York, NY: Academic Press. 78–85.

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Authors
Martiny, K., Refsgaard, E., Lund, V., Lunde, M., Sørensen, L., Thougaard, B., Lindberg, L., & Bech, P.
Affiliations
  • Copenhagen University Hospital (DK)
  • Bispebjerg Hospital (DK)
Corresponding author
Martiny, Klaus
ORCID
Venue
PLoS ONE
Publisher
Public Library of Science (PLoS)
Published
2013-06-28
Volume
8
Issue
6
Pages
e67264
ISSN
1932-6203 (ISSN-L)
DOI
10.1371/journal.pone.0067264
PMC
PMC3696105
OpenAlex
W2062067529
Cited by
43
References
34
Citations by year
2026: 3 · 2025: 2 · 2024: 2 · 2023: 1 · 2022: 2 · 2021: 2 · 2020: 9 · 2019: 3 · 2018: 6 · 2017: 4 · 2016: 2 · 2015: 4 · 2014: 3
FWCI
1.96
Type
journal article
Language
en
Update notices
correction (2013-10-16)
Open access
Licence
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • Figshare (submittedVersion, cc-by)
  • Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
Funders
  • Eli Lilly and Company
  • AstraZeneca
  • Universität Basel
  • Sundhed og Sygdom, Det Frie Forskningsråd
  • Servier
  • H. Lundbeck A/S
  • Forsknings- og Innovationsstyrelsen
  • Medical Research Council
  • Danish Agency for Science and Higher Education
Topics
  • Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
Keywords
wake therapy, sleep deprivation, major depressive disorder, phototherapy, daily exercise, napping, predictors of treatment response, remission, inpatient depression treatment
MeSH terms
Adult, Affect, Aged, Behavior Therapy, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Surveys and Questionnaires, Sleep Deprivation, Treatment Outcome, Young Adult

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