Sleep deprivation as an effective anti-depressant...

[Geo]

Sleep deprivation is an effective anti-depressant for nearly half of depressed patients, study suggests


Sleep deprivation -- typically administered in controlled, inpatient settings -- rapidly reduces symptoms of depression in roughly half of depression patients, according the first meta-analysis on the subject in nearly 30 years, from researchers at the Perelman School of Medicine at the University of Pennsylvania. Partial sleep deprivation (sleep for three to four hours followed by forced wakefulness for 20-21 hours) was equally as effective as total sleep deprivation (being deprived of sleep for 36 hours), and medication did not appear to significantly influence these results. The results are published today in the Journal of Clinical Psychiatry.

Although total sleep deprivation or partial sleep deprivation can produce clinical improvement in depression symptoms within 24 hours, antidepressants are the most common treatment for depression. Such drugs typically take weeks or longer to experience results, yet 16.7 percent of 242 million U.S. adults filled one or more prescriptions for psychiatric drugs in 2013. The findings of this meta-analysis hope to provide relief for the estimated 16.1 million adults who experienced a major depressive episode in 2014.

Previous studies have shown rapid antidepressant effects from sleep deprivation for roughly 40-60 percent of individuals, yet this response rate has not been analyzed to obtain a more precise percentage since 1990 despite more than 75 studies since then on the subject.

"More than 30 years since the discovery of the antidepressant effects of sleep deprivation, we still do not have an effective grasp on precisely how effective the treatment is and how to achieve the best clinical results," said study senior author Philip Gehrman, PhD, an associate professor of Psychiatry and member of the Penn Sleep Center, who also treats patients at the Cpl. Michael J. Crescenz VA Medical Center. "Our analysis precisely reports how effective sleep deprivation is and in which populations it should be administered."

Reviewing more than 2,000 studies, the team pulled data from a final group of 66 studies executed over a 36 year period to determine how response may be affected by the type and timing of sleep deprivation performed (total vs early or late partial sleep deprivation), the clinical sample (having depressive or manic episodes, or a combination of both), medication status, and age and gender of the sample. They also explored how response to sleep deprivation may differ across studies according to how "response" is defined in each study.

"These studies in our analysis show that sleep deprivation is effective for many populations," said lead author Elaine Boland, PhD, a clinical associate and research psychologist at the Cpl. Michael J. Crescenz VA Medical Center. "Regardless of how the response was quantified, how the sleep deprivation was delivered, or the type of depression the subject was experiencing, we found a nearly equivalent response rate."

The authors note that further research is needed to identify precisely how sleep deprivation causes rapid and significant reductions in depression severity. Also, future studies are needed to include a more comprehensive assessment of potential predictors of treatment outcome to identify those patients most likely to benefit from sleep deprivation.

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https://www.sciencedaily.com/releases/2017/09/170919140416.htm

[Buster's Uncle]

Doesn't pass the smell test.

[Geo]

Neither does it to me.

But perhaps we're not part of the "lucky" half?

[Buster's Uncle]

Perhaps.  One imagines the effect observed is something to do with rocking the brain out of a rut - and I can't believe there would be a long-term positive effect, au contraire, nor can I imagine very practical clinical application.  Maybe it might work for someone not especially prone to depression to begin with.  I would, without any possible doubt, be depressed again -IF it worked at all, and it wouldn't; I've pulled all-nighters a few times- within a few days unless it was tried when my cycle was already ready to change over.

For sure, I sleep more soundly in the low-energy end of my cycles - but I can't believe that feeling like crap all day is good for me.  A good night's sleep is decidedly mood-positive.

[Geo]

If only the toddler on the floor below would keep quiet at night all the time. Or their laundry machine not working at night on Wednesdays. Or...
I definitely prefer the afternoon shift where I can get up whenever I want.

[Buster's Uncle]

This is a major reason I have a fan in my room running at night whatever the temperature or season...

[Unorthodox]

I thought depression caused my sleep deprivation. 

But then, I might not count, since 4 hour nights are not completely aberrant to begin with. 

[ColdWizard]

I'm not dropping $40 for it but I would first question this meta-study's analysis of sleep deprivation on the "definition of response (eg, 30% reduction in depression ratings)".


Degrading attention, decision making, and memory seems a poor trade-off in almost any case. The cynic in me thinks this is just churn in the grant -> study -> publish -> grant grind but I'm probably sleep deprived.

[Buster's Uncle]

Yo - now I want to know if the Journal of Clinical Psychiatry is a valid peer-reviewed journal or what...  One hopes Science Daily is competent enough for that not to be a good question...

[Unorthodox]

Yo - now I want to know if the Journal of Clinical Psychiatry is a valid peer-reviewed journal or what... 

That's a google rabbit-hole...

[Buster's Uncle]

I've never noticed any problems with Science Daily.  [shrugs]  Nobody ever put up a notice reading "We're a scam site[/journal, whatever]" or "we're sloppy and/or just not trying" or "Welcome to nextBigfuture.  China ROOOLZ!"

[ColdWizard]

The Information Age appears to include the prefixes of of Mis- and Dis- by default. The Journal says it's peer-reviewed, for what it's worth.

[Buster's Uncle]

I really can see a possibility that it might could work in the right cases -dubious as that sounds for reasons we've mentioned- because a lot of mood disorder problems run on cycles -mine sure as heck do, if not steady ones- and I 'spose the right sleep deprivation could disrupt the cycle like putting out an oil well fire with a bomb...

[Lorizael]

I'm not sure where, but I've encountered this sleep deprivation as depression treatment thing before. I thought I recall seeing that the benefits were short-lived. So yeah, I am already tired all the time (because depression messes with sleep), so short-lived relief at the cost of even more fatigue seems like a pretty terrible idea.

[Buster's Uncle]

  The interwebs ate a much longer post. 

It does stand to reason that any valid effect possibly observed shouldn't survive the negatives of sleep deprivation by long.  -Thus my remark about practical clinical applications being hard to imagine.  How freaking depressed would I have to be to be willing spend even one sleepless night a month in a medical facility? 

Protip: being in medical facilities has an unfortunate tendency to annoy me - as in, I am easily filled with rage at the paperwork and waiting and the dehumanizing way the system treats people.  Rage burns out and leads to suicidal depression.  QED, it wouldn't work for me even if it worked for me...