Lack of sleep as a treatment of depression

Published: 06-12-2019

Last modified: 02-03-2021

Insomnia often accompanies depression, but it turns out that lack of sleep can also help treat depression. This was first noticed in the 1970s, when sleep deprivation studies were conducted to better understand depression. Surprisingly, in people with symptoms of depression, deprivation of sleep caused an improvement in mood. No mood changes were noted in people without depression.

In the following years more research was conducted on this subject. An improvement in mood after a sleep deprivation session (i.e. deprivation of sleep for 36 hours) is observed in approximately 60% of patients. Better results were obtained in patients with endogenous (biological) depression than reactive (caused by stressful events) and better with bipolar depression (depressive episodes alternating with manic episodes) than unipolar one. It is interesting that sleep deprivation causes similar neurochemical changes in the brain as antidepressants. In addition, patients who are resistant to antidepressant drugs also have less improvement after sleep deprivation, while people who feel better after sleep deprivation usually also respond well to medications. Unfortunately, the disadvantage of sleep deprivation treatment is that the effect lasts very shortly. After the next, normally sleeping nights, the symptoms of depression return to the starting point.

The solution is, instead of sleepless nights, to shift the sleep-wake cycle so as to fall asleep and wake up earlier. Studies have shown that what works as an antidepressant is lack of sleep in the second half of the night. To shift the sleep phase, the patient is advised not to sleep for one night and then go to bed several hours earlier than usual.

Sleep deprivation and sleep-wake cycles shifts are often combined with medications or phototherapy. Studies show that light treatment can extend the therapeutic effect of sleep deprivation.

It seems that the sleep-wake cycle therapies are very promising and there will definitely be further research. They are cheap, safe, have few contraindications and side effects.

Reference:

Magdalena Chojnacka, Łukasz Święcicki (2012). Niefarmakologiczne terapie chronobiologiczne stosowane w leczeniu depresji. Neuropsychiatria i Neuropsychologia, 7, 3, 148-157.

Author: Maja Kochanowska