Can sleep deprivation be used to treat depression?

Sleep deprivation – typically administered in controlled, inpatient settings – ‘rapidly’ reduces symptoms of depression in roughly half of patients, according to research by the University of Pennsylvania.

They found that 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 have been published 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.

Previous studies have shown rapid antidepressant effects from sleep deprivation for between 40 and 60 per cent of patients, yet this response rate has not been analysed to obtain a more precise percentage since 1990 despite more than 75 studies since then on the subject.

The study’s senior author, Philip Gehrman, said: ‘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,”

‘Our analysis precisely reports how effective sleep deprivation is and in which populations it should be administered.’

The researchers reviewed more than 2,000 studies, and used data from a final group of 66 of them which were carried out 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.

The study’s lead author, Elaine Boland, said: ‘These studies in our analysis show that sleep deprivation is effective for many populations.’

‘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.