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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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“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
In the citing paper
“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]
In the citing paper
“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 Loss and the Socio-Emotional Brain
Simon, E. B., Vallat, R., Barnes, C. M., & Walker, M. P. (2020) · Trends in Cognitive Sciences · doi:10.1016/j.tics.2020.02.003 · Cited by 261
Bidirectional relationship between sleep and depression
Yasugaki, S., Okamura, H., Kaneko, A., & Hayashi, Y. (2023) · Neuroscience Research · doi:10.1016/j.neures.2023.04.006 · Cited by 231
Gottlieb, J. F., Benedetti, F., Geoffroy, P. A., Henriksen, T. E. G., Lam, R. W., Murray, G., Phelps, J., Sit, D., Swartz, H. A., Crowe, M., et al. (2019) · Bipolar Disorders · doi:10.1111/bdi.12847 · Cited by 196
Self-citationAdenosine, caffeine, and sleep–wake regulation: state of the science and perspectives
Reichert, C. F., Deboer, T., & Landolt, H. (2022) · Journal of Sleep Research · doi:10.1111/jsr.13597 · Cited by 183
“Unfortunately, the wakefulness-induced mood improvement is typically short-lived and followed by a relapse into the depressive state upon recovery sleep (Boland et al., 2017).”
BackgroundThe sleep–circadian interface: A window into mental disorders
Meyer, N., Lok, R., Schmidt, C., Kyle, S. D., McClung, C. A., Cajochen, C., Scheer, F. A. J. L., Jones, M. W., & Chellappa, S. L. (2024) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2214756121 · Cited by 190
Metadata
- 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 (medical) › 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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