It may sound counter-intuitive, but for decades it has been known that sleep deprivation can rapidly alleviate symptoms of depression. A new meta-analysis from a team at the University of Pennsylvania has examined more than 30 years worth of studies on the strange phenomenon and concluded that sleep deprivation can result in antidepressant effects in up to 50 percent of people.
Nearly 200 years ago, a German psychiatrist named Johann Christian August Heinroth successfully experimented with sleep deprivation as a treatment for, what he called at the time "melancholia." Over recent decades the phenomenon has become a major area of study for psychologists and a process called Wake Therapy was developed to quickly alleviate major depressive symptoms and jumpstart treatment with antidepressant drugs.
"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," says senior author of the new study Philip Gehrman.
In compiling the meta-analysis the team focused on 66 studies (out of a pool of more than 2,000) to understand what variables either increase or decrease the efficacy of a sleep deprivation treatment for depression. In generating its findings the team took into account age, gender, accompanying medications and different types of sleep deprivation (i.e total, partial, early or late).
The results showed that sleep deprivation was effective across the board, regardless of demographics or delivery technique. In studies with a randomized control group, positive responses were identified 45 percent of the time, while in studies without a control group, positive responses hit 50 percent.
"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," says Gehrman.
One of the biggest challenges researchers now face in translating this seemingly odd, but longstanding phenomenon into a practical treatment is the fact that the effects of sleep deprivation on depression are not long-lasting. Depressive symptoms tend to recur anywhere from one day to one week after a treatment.
And pragmatically, sleep deprivation isn't a long-term solution to depression, with many studies correlating chronic insomnia and sleep disruption as actually being a trigger for depressive symptoms. But the research does point to some fundamentally fascinating conclusions about how our brains function. A study from 2015 discovered that sleep deprivation influences the same mood-regulating receptor in the frontal lobe as ketamine and tricyclic antidepressants.
Some clinicians are also experimenting with chronotherapy as a way to extend the short-lived anti-depressant effects of sleep deprivation. The treatment combines sleep deprivation with a timed sleep schedule and bright light therapy (a timed exposure to full-spectrum light at key times throughout the day).
While this new meta-analysis does solidify a positive correlation between sleep deprivation and a reduction in depressive symptoms, this isn't a cue for sufferers to start randomly pulling all-nighters. Sleep deprivation can certainly assist in alleviating the effects of an acute depressive episode, but long-term sleep disruption is not recommended. More research still needs to be done to understand how sleep deprivation actually results in this positive effect, but there are hopes this could lead to the development of new drugs that can replicate the effect without forcing a patient to sacrifice a good night's sleep.
The new study was published in The Journal of Clinical Psychiatry.
Source: Penn Medicine
