THERAPEUTIC AND MECHANISTIC EFFECTS OF SLEEP DEPRIVATION IN DEPRESSION

睡眠剥夺对抑郁症的治疗作用和机制作用

基本信息

批准号：
3781431
负责人：
R M POST
金额：
--
依托单位：
NATIONAL INSTITUTE OF MENTAL HEALTH
依托单位国家：
美国
项目类别：
财政年份：
资助国家：
美国
起止时间：
至
项目状态：
未结题

项目摘要

One night's total sleep deprivation can induce profound antidepressant effects in depressed patients. Following the absence of sleep for one night, 40-60% of depressed patients typically show the transient onset of mood improvement which is then lost following a nap or the next night's recovery sleep. Thus, the sleep deprivation paradigm becomes a non- pharmacological means of acutely inducing altered mood states in a fashion that may yield important information about underlying mechanisms. While the mood changes are usually transient they may, nonetheless, give insights into neural systems involved in mood dysregulation and its acute reversal. Some patients show stable degrees of improvement following sleep deprivations, while others show tolerance and yet others show a relative refractoriness to sleep deprivation-induced mood improvement early in their bipolar depressive episode, but vulnerability to transient or long-lasting switches out of depression later in the course of their episode. These data provide some of the first systematic observations regarding differential neurobiological responsiveness as a function of the course of a bipolar depressive episode. Although increases in TSH secretion may be associated with the degree of clinical response to sleep deprivation, the findings do not reach statistical significance in our patient population as a whole. Patients with greater degrees of diurnal variation in mood on the baseline day prior to sleep deprivation show greater antidepressant response compared with those without diurnal variation.

一晚的完全睡眠剥夺会引起深刻的抗抑郁药在抑郁症患者中的影响。在没有睡眠之后晚上，40-60％的抑郁症患者通常显示情绪改善，然后在午睡或第二天晚上失去恢复睡眠。因此，睡眠剥夺范式变成了非急性诱导情绪状况改变的药理方法可能产生有关潜在机制的重要信息的时尚。尽管情绪变化通常是短暂的，但它们仍然可以给予对涉及情绪失调及其急性的神经系统的见解逆转。一些患者显示出稳定的改善程度睡眠剥夺，而其他人则表现出宽容，而其他人则表现出相对的耐睡眠剥夺引起的情绪改善在双极性抑郁发作的早期，但易于短暂性或持续的持久切换在后期的抑郁症中插曲。这些数据提供了一些第一个系统观察关于差异神经生物学反应性作为双极性抑郁发作的过程。尽管TSH的增加分泌可能与对睡眠的临床反应程度有关剥夺，调查结果在我们的整个患者人数。昼夜程度更高的患者睡眠剥夺前一天的基线一天情绪变化与没有昼夜的反应相比，抗抑郁药反应更大变化。