Total sleep deprivation followed by sleep phase advance and bright light therapy in drug-resistant mood disorders

2013 ◽  
Vol 144 (1-2) ◽  
pp. 28-33 ◽  
Author(s):  
Masaru Echizenya ◽  
Hideka Suda ◽  
Masahiro Takeshima ◽  
Yoshiyuki Inomata ◽  
Tetsuo Shimizu
Keyword(s):  
Sleep Deprivation ◽  
Mood Disorders ◽  
Bright Light ◽  
Light Therapy ◽  
Phase Advance ◽  
Drug Resistant ◽  
Bright Light Therapy ◽  
Sleep Phase ◽  
Total Sleep Deprivation

scholarly journals Total Sleep Deprivation Followed by Bright Light Therapy as Rapid Relief for Depression: A Pragmatic Randomized Controlled Trial

2021 ◽  
Vol 12 ◽  
Author(s):  
Michael Ioannou ◽  
Zoltán Szabó ◽  
Mats Widmark-Jensen ◽  
Georgios Vyrinis ◽  
Christopher Karlsson ◽  
...  
Keyword(s):  
Sleep Deprivation ◽  
Standard Treatment ◽  
Real Life ◽  
Bright Light ◽  
Light Therapy ◽  
Bright Light Therapy ◽  
Total Sleep Deprivation ◽  
Randomized Controlled ◽  
Rapid Relief

Background: Total sleep deprivation (TSD) combined with bright light therapy (BLT) has been suggested as a valuable add-on to standard treatment for rapid relief of depression. However, there is a lack of randomized controlled trials in real-life clinical settings. The aim of this pragmatic randomized clinical trial was to investigate the effectiveness, acceptance, and feasibility of TSD combined with BLT as add-on to standard treatment for depression in a real-life clinical setting.Methods: Thirty-three inpatients were randomly assigned to either: a) an intervention group receiving a single-night TSD followed by 6 days BLT (10.000 lux, 30 min/day) as add-on to standard treatment; or b) a control group receiving a short sleep-hygiene consultation in addition to standard treatment. The follow-up period was 1 week.Results: No statistical differences were found in response rates, reduction of depressive and insomnia symptoms, length of stay, readmission rate, and clinical improvement. Both groups reported positive experiences toward the received treatment with low drop-out rates.Conclusions: One-night TSD followed by BLT was not effective as a rapid relief for depression at 1-week follow-up; however, the treatment was feasible and well-tolerated.

Combined Total Sleep Deprivation and Light Therapy in the Treatment of Drug-Resistant Bipolar Depression

2005 ◽  
Vol 66 (12) ◽  
pp. 1535-1540 ◽  
Author(s):  
Francesco Benedetti ◽  
Barbara Barbini ◽  
Mara Cigala Fulgosi ◽  
Cristina Colombo ◽  
Sara Dallaspezia ◽  
...  
Keyword(s):  
Sleep Deprivation ◽  
Bipolar Depression ◽  
Light Therapy ◽  
Drug Resistant ◽  
Total Sleep Deprivation

Total sleep deprivation and consecutive sleep-phase-advance therapy as fast acting antidepressive strategy

1997 ◽  
Vol 42 (1) ◽  
pp. 77S
Author(s):  
M. Berger ◽  
A. König ◽  
F. Hohagen ◽  
A. Kjemen ◽  
M. Homyak ◽  
...  
Keyword(s):  
Sleep Deprivation ◽  
Phase Advance ◽  
Sleep Phase ◽  
Total Sleep Deprivation ◽  
Fast Acting

scholarly journals Chronobiology and mood disorders

2003 ◽  
Vol 5 (4) ◽  
pp. 315-325 ◽  
Keyword(s):  
Circadian Rhythms ◽  
Sleep Deprivation ◽  
Mood Disorders ◽  
Seasonal Affective Disorder ◽  
Bright Light ◽  
Mood Stabilizers ◽  
Phase Advance ◽  
Diagnostic Systems ◽  
Recovery Sleep

The clinical observations of diurnal variation of mood and early morning awakening in depression have been incorporated into established diagnostic systems, as has the seasonal modifier defining winter depression (seasonal affective disorder, SAD). Many circadian rhythms measured in depressive patients are abnormal: earlier in timing, diminished in amplitude, or of greater variability. Whether these disturbances are of etiological significance for the role of circadian rhythms in mood disorders, or a consequence of altered behavior can only be dissected out with stringent protocols (eg, constant routine or forced desynchrony). These protocols quantify contributions of the circadian pacemaker and a homeostatic sleep process impacting on mood, energy, appetite, and sleep. Future studies will elucidate any allelic mutations in "circadian clock" -related or "sleep"-related genes in depression. With respect to treatment, antidepressants and mood stabilizers have no consistent effect on circadian rhythmicity. The most rapid antidepressant modality known so far is nonpharmacological: total or partial sleep deprivation in the second half of the night. The disadvantage of sleep deprivation, that most patients relapse after recovery sleep, can be prevented by coadministration of lithium, pindolol, serotonin (5-HT) reuptake inhibitors, bright light, or a subsequent phase-advance procedure. Phase advance of the sleep-wake cycle alone also has rapid effects on depressed mood, which lasts longer than sleep deprivation. Light is the treatment of choice for SAD and may prove to be useful for nonseasonal depression, alone or as an adjunct to medication. Chronobiological concepts emphasize the important role of zeitgebers to stabilize phase, light being the most important, but dark (and rest) periods, regularity of social schedules and meal times, and use of melatonin or its analogues should also be considered. Advances in chronobiology continue to contribute novel treatments for affective disorders.

scholarly journals Triple chronotherapy for the rapid treatment and maintenance of response in depressed outpatients: a feasibility and pilot randomised controlled trial

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S58-S58
Author(s):  
David Veale ◽  
Marc Serfaty ◽  
Clara Humpston ◽  
Andriani Papageorgiou ◽  
Sarah Markham ◽  
...  
Keyword(s):  
Sleep Deprivation ◽  
Rating Scale ◽  
Clinical Sample ◽  
Controlled Trial ◽  
Bright Light ◽  
Light Therapy ◽  
Phase Advance ◽  
Control Group ◽  
Significant Difference ◽  
Rapid Treatment

AimsTriple chronotherapy (defined as sleep deprivation for 36 hours, followed by 4 days of advancing the time of sleep, together with daily morning bright light therapy for 6 months) has demonstrated benefits for the rapid treatment of depressive symptoms in 4 small, controlled trials of in-patients. Our aims were to test the feasibility of recruitment and delivery of triple chronotherapy for out-patients with depression.MethodIn a single blind trial, 82 participants were randomised to either triple chronotherapy or a control intervention. The primary outcome was Hamilton Depression Rating Scale 6 item (HAM-D6) at 1 week. Timings of observer ratings were baseline; 1 week; 2 weeks; 4 weeks; 8 weeks and 26 weeks after randomisation. Triple chronotherapy consisted of (a) Total sleep deprivation for 36 hours. On Day 1 patients were supported in a small group to stay awake at night with an occupational therapist, (b) Phase Advance of Sleep over 4 days. Phase Advance began after the first night of sleep deprivation, when they left the hospital at about 8am and were asked to go to bed earlier at about 5pm and rise at about 1am. Their sleep and wake up times were then shifted 2 hours later on each of the following three days until they attained their usual bedtime again at about 11pm.As a control for the triple chronotherapy, participants were given psychoeducation and written information on sleep hygiene. They were also given SomniLight amber light daily for 1 week in the morning.ResultParticipants in the triple chronotherapy group were able to stay awake for the planned thirty-six hours and 89.9% adhered to the plan of phase advance of their sleep over the following 4 days. We achieved our recruitment target with 60 participants having completed the trial within 13 months. There were no reported adverse side effects. We explored outcomes and found a significant difference between the groups for the HAM-D6 at week 1, 8 and 26. Response (> 50% reduction in symptoms) was achieved by 52% in the triple chronotherapy group compared to 18% in the control group at week 1. This gradually increased to 70% achieving response in the triple chronotherapy group at week 26 compared to 22% in the control group.ConclusionTriple chronotherapy produced a significant and rapid benefit after 1 week in out-patients with depression that was sustained at 26 weeks. Further cost-effective trials with a larger clinical sample size are required.

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