Meta-analysis of the antidepressant effects of acute sleep deprivation
Abstract
OBJECTIVE: To provide a quantitative meta-analysis of the antidepressant effects of sleep deprivation to complement qualitative reviews addressing response rates. DATA SOURCES: English-language studies from 1974 to 2016 using the keywords sleep deprivation and depression searched through PubMed and PsycINFO databases. STUDY SELECTION: A total of 66 independent studies met criteria for inclusion: conducted experimental sleep deprivation, reported the percentage of the sample that responded to sleep deprivation, provided a priori definition of antidepressant response, and did not seamlessly combine sleep deprivation with other therapies (eg, chronotherapeutics, repetitive transcranial magnetic stimulation). DATA EXTRACTION: Data extracted included percentage of responders, type of sample (eg, bipolar, unipolar), type of sleep deprivation (eg, total, partial), demographics, medication use, type of outcome measure used, and definition of response (eg, 30% reduction in depression ratings). Data were analyzed with meta-analysis of proportions and a Poisson mixed-effects regression model. RESULTS: The overall response rate to sleep deprivation was 45% among studies that utilized a randomized control group and 50% among studies that did not. The response to sleep deprivation was not affected significantly by the type of sleep deprivation performed, the nature of the clinical sample, medication status, the definition of response used, or age and gender of the sample. CONCLUSIONS: These findings support a significant effect of sleep deprivation and suggest the need for future studies on the phenotypic nature of the antidepressant response to sleep deprivation, on the neurobiological mechanisms of action, and on moderators of the sleep deprivation treatment response in depression.
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Sleep deprivation is effective for the acute treatment of bipolar depression.
“Recent meta‐analysis found that sleep deprivation is effective for the acute treatment of bipolar depression (Boland et al., 2017).”
From Adjunctive bright light therapy for treating bipolar depression: A systematic review and meta‐analysis of randomized controlled trials (2020) · cites this paper as Boland et al., 2017
Meta-analyses on TSD have shown divergent conclusions on its efficacy, primarily explained by differences in inclusion criteria.
“Meta-analyses on TSD have shown divergent conclusions on its efficacy, primarily explained by differences in inclusion criteria (10–12, 45–47).”
From Total Sleep Deprivation Followed by Bright Light Therapy as Rapid Relief for Depression: A Pragmatic Randomized Controlled Trial (2021) · cites this paper as [45]
Recent studies on combined chronotherapy have reported lower response rates than the presumed average of 50% with the exception of two cohort studies.
“Moreover, recent studies on combined chronotherapy have reported lower response rates (20, 39, 44, 58) than the presumed average of 50% (45) with the exception of two cohort studies (22, 62).”
From Total Sleep Deprivation Followed by Bright Light Therapy as Rapid Relief for Depression: A Pragmatic Randomized Controlled Trial (2021) · cites this paper as [45]
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“Sleep deprivation (SD) is a method of chronotherapy of depression, with well-documented efficacy at the level of 45–50% (Boland et al. 2017).”
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Ghrelin’s role in sleep and sleep deprivation: a narrative review
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“DS has long been recognized for its transient antidepressant effects, with some individuals experiencing rapid mood improvement after even a single night of lost sleep (10).”
White matter microstructural perturbations after total sleep deprivation in depression
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“Although the therapeutic effects of TSD are only brief and symptoms return after a full night of recovery sleep (7), its rapid effect on mood serves as a model to understand the biological mechanisms associated with fastacting antidepressant response.”
BackgroundResultSleep Deprivation and Its Consequences
Chernyshev, O. Y. (2023) · CONTINUUM Lifelong Learning in Neurology · doi:10.1212/con.0000000000001323 · Cited by 7 · see citing works
Linking sleep patterns to eye health: a review of current understanding and future directions
Xuan, S., & Li, Z. (2025) · Visual Neuroscience · doi:10.48130/vns-0025-0008 · Cited by 8 · see citing works
High neuroticism is associated with reduced negative affect following sleep deprivation
Saksvik‐Lehouillier, I., Langvik, E., Saksvik, S. B., Kallestad, H., Follesø, H. S., Austad, S. B., Dahlberg, J., Ringen, H., Tanum, T. K., Sørengaard, T. A., et al. (2021) · Personality and Individual Differences · doi:10.1016/j.paid.2021.111291 · Cited by 6 · see citing works
Role of adjunctive nonpharmacological strategies for treatment of rapid-cycling bipolar disorder
Chakrabarti, S., Jolly, A. J., Singh, P., & Yadhav, N. (2023) · World Journal of Psychiatry · doi:10.5498/wjp.v13.i8.495 · Cited by 5 · see citing works
Dopamine’s reach: Unlocked by sleep loss
Sulaman, B. A., Kudlak, T., & Eban-Rothschild, A. (2024) · Neuron · doi:10.1016/j.neuron.2023.11.015 · Cited by 5 · see citing works
Palatine, E., Phillips, M. L., & Soehner, A. M. (2024) · Journal of Affective Disorders · doi:10.1016/j.jad.2024.03.058 · Cited by 6 · see citing works
Therapie psychischer Erkrankungen
Lieb, K., Jacob, G. A., Brückner, A., & Frauenknecht, S. (2019) · Elsevier eBooks · doi:10.1016/b978-3-437-23491-0.00003-8 · Cited by 5 · see citing works
Exploring the Complex Relationship Between Sleep, Depression and the Immune System
Arıcıoğlu, F., & Çetin, M. (2020) · Psychiatry and Clinical Psychopharmacology · doi:10.5455/pcp.20201207094228 · Cited by 4 · see citing works
Xu, L., Zhang, H., Zhang, J., Zhang, X., & Zhang, J. (2025) · Sleep Medicine · doi:10.1016/j.sleep.2025.106665 · Cited by 4 · see citing works
Benasi, G., Cheng, B., Aggarwal, B., & St‐Onge, M. (2024) · Sleep Medicine · doi:10.1016/j.sleep.2024.02.001 · Cited by 4 · see citing works
Does a Meta-Analysis of Sleep Deprivation Studies Demonstrate Efficacy?
Stewart, J. W. (2018) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.17lr12018 · Cited by 4 · see citing works
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Correspondence between sleep patterns and anhedonia in adult male mice exposed to early-life stress
Hall, A. G., Burek, D., Hisey, E. E., Seabrook, L. T., Fritsch, E. L., Foilb, A. R., Beatty, Z. G., Ressler, K. J., Kangas, B. D., & Carlezon, W. A. (2025) · Translational Psychiatry · doi:10.1038/s41398-025-03574-2 · Cited by 5 · see citing works
Sochal, M., Ditmer, M., Białasiewicz, P., Turkiewicz, S., Karuga, F. F., & Gabryelska, A. (2023) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2023.1332831 · Cited by 3 · see citing works
“Even though DS was demonstrated to exert a mood-enhancing effect in depressive patients, it remains unclear whether cognitive decrement in this population is similar to this in the general population (4, 5, 41, 42).”
Boujelbane, M. A., Trabelsi, K., Jahrami, H., Ammar, A., Salem, A., Kerkeni, M., Charfi, A., Boukhris, O. F., Clark, C. C. T., Roufayel, R., et al. (2025) · Health Science Reports · doi:10.1002/hsr2.70692 · Cited by 3 · see citing works
“According to some studies, reduction in depressive symptoms is also linked to acute reduced sleep duration [53, 54].”
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
“However, it is mostly transient, and relapse commonly occurs in about 80% after the next full sleep or nap (Wu and Bunney 1990; Hemmeter et al. 2010; Boland et al. 2017).”
InfluentialAntidepressant effects of acute sleep deprivation are reduced in highly controlled environments
Goldschmied, J., Boland, E. M., Palermo, E. H., Barilla, H., Dinges, D. F., Detre, J. A., Basner, M., Sheline, Y. I., Rao, H., & Gehrman, P. (2023) · Journal of Affective Disorders · doi:10.1016/j.jad.2023.07.116 · Cited by 4 · see citing works
Self-citationRegen, F., & Benkert, O. (2018) · Springer eBooks · doi:10.1007/978-3-662-57334-1_1 · Cited by 3 · see citing works
Regulatory proposals to support athlete mental health in the Race Across America
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Connecting mechanistic evidence for depression, anxiety, and insomnia with neuroimaging
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Larson, O., Basner, M., Rao, H., Barilla, H., Boland, E. M., Goldschmied, J., Jones, C. W., Sheline, Y. I., Detre, J. A., Thase, M. E., et al. (2025) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2025.09.062 · Cited by 1 · see citing works
“A single night of acute sleep deprivation (SD) has been shown to lead to rapid and pronounced improvement in mood symptoms for up to 50 % of individuals with clinical depression (Boland et al., 2017).”
Self-citationBaghdad, W., Brouzi, M. Y. E., Ibouzine‐Dine, L., Abouyaala, O., Arbaoui, M. E., Kessam, F. Z., Dimaoui, A., Mallouk, H., Lamtai, M., Satté, A., et al. (2026) · Neurochemical Research · doi:10.1007/s11064-026-04788-6 · Cited by 2 · see citing works
“…but given the many adverse effects observed in various animal models, it can be assumed that humans are also vulnerable to SD-induced neurodegeneration and that biomarkers of SD-induced neuronal damage validated in rodents can be used to assess and better understand such damage in humans.”
Sleep: Never Wasted but Often Too Short
Kantermann, T. (2019) · Current Biology · doi:10.1016/j.cub.2018.12.030 · Cited by 1 · see citing works
Sleep, Emotional Memories, and Depression
Bovy, L., Tendolkar, I., Fernández, G., & Dresler, M. (2019) · Handbook of behavioral neuroscience · doi:10.1016/b978-0-12-813743-7.00034-7 · Cited by 2 · see citing works
Regen, F., & Benkert, O. (2020) · Springer eBooks · doi:10.1007/978-3-662-61753-3_1 · Cited by 1 · see citing works
- Authors
- 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.
- Affiliations
- Philadelphia VA Medical Center (US)
- University of Pennsylvania (US)
- ORCID
- Venue
- The Journal of Clinical Psychiatry
- Publisher
- Physicians Postgraduate Press, Inc
- Published
- 2017-10-25
- Volume
- 78
- Issue
- 8
- Pages
- e1020-e1034
- ISSN
- 0160-6689 (ISSN-L)
- OpenAlex
- W2754688243
- Cited by
- 132
- References
- 0
- Citations by year
- 2026: 15 · 2025: 14 · 2024: 10 · 2023: 16 · 2022: 5 · 2021: 17 · 2020: 26 · 2019: 20 · 2018: 9
- FWCI
- 1.90
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pharmacology › Treatment of Major Depression
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Neurology › Transcranial Magnetic Stimulation Studies
- Keywords
- sleep deprivation, antidepressant effects, depression, major depressive disorder, bipolar depression, total sleep deprivation, sleep restriction, treatment moderators
- MeSH terms
- Antidepressive Agents, Depression, Humans, Phototherapy, Psychiatric Status Rating Scales, Psychological Techniques, Sleep Deprivation, Treatment Outcome, Transcranial Magnetic Stimulation
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