Sleep is disturbed in depression:
- slow wave sleep (stages 3 & 4) is reduced
- more frequent awakening, especially as morning approaches
- REM occurs earlier
- 1st half of the night contains a higher proportion of REM
Selective deprivation of REM sleep using EEG recordings gradually improve depression over several weeks
that’s all I have to say about that
Most anti-depressant drugs suppress ___regardless of their pharm effects
REM sleep: 1. they delay onset and decrease duration of REM sleep
2. one anti-depressant drug did not have this effect, suggesting REM suppression is not the only way to achieve anti-depressant effect
SWS deprivation associated with
improved mood:
- mood improved after single night of deprivation
- Decreased REM accompanied SWS deprivation so may have been involved
What does total sleep deprivation produce?
Immediate depression relief (in contrast to selective REM deprivation which takes weeks to show effects):
- about 2/3 of depressed patients respond to total sleep deprivation
- people with fluctuating mood most likely to respond; unchanging mood less likely to respond
Theory that a depressogenic substance is produced during sleep, and sleep deprivation prevents it from being produced…even a nap can reverse effects
that’s all
Partial and intermittent total sleep deprivation (2x per week for 4 weeks) can do what to mood and effects of meds?
Improve mood and speed effects of anti-depressant meds
SAD
- winter version most common
- lethargy
- sleep disturbance
- carbo craving and weight gain - summer version infrequent
- decreased sleep
- decreased appetite and weight loss
Study of SAD and families
- one study found sad runs in families
- 29% of variance accounted for by genetic factors
- appears to be related to genes that control 5HT transporter and 5HT receptor
Phototherapy effective treatment for SAD and may serve as a Zeitgeber to normalize the timing of melatonin release
- in normals melatonin release begins 6 hours before the mid-point of sleep
- people with SAD often start melatonin secretion early so the length of time until sleep mid-point is greater – called phase delay
- or they may start melatonin secretion late – called phase advance
- people with SAD may need a stronger Zeitgeber to reset their circadian rhythm and phototherapy may serve as a Zeitgeber to reset release melatonin to proper time
- phototherapy also effective for MDD, especially in conjunction with antidepressants
- patients less likely to relapse if given phototherapy after sleep deprivation treatment - one hour walk outside in the morning even of an overcast day reduced sxs of sad
Nothing to see here
Exercise in general found to do what to mood and sleep of geriatric patients?
improve depression and sleep
