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

• 批准号: 3845308
• 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
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3845308
• 关键词: antidepressants; bipolar depression depressed phase; circadian rhythms; clinical depression; hormone regulation /control mechanism; human subject; neurobiology; sleep deprivation; thyrotropin

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. Preliminary data suggest that increases in TSH secretion may be associated with the degree of clinical response to sleep deprivation in our patient population as a whole, as well as individual case studies. 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 急性诱导情绪状态的非药理学手段 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。 初步数据建议 TSH分泌的增加可能与 我们患者人群对睡眠剥夺的临床反应 整体以及个人案例研究。 较高程度的患者 睡眠前一天的基线日情绪变化 与那些相比，剥夺显示出更大的抗抑郁反应 没有昼夜变化。