THERAPEUTIC AND MECHANISTIC EFFECTS OF SLEEP DEPRIVATION IN DEPRESSION

一整晚的睡眠剥夺可以产生大量的抗抑郁药物 对抑郁症患者的影响。在一个人没有睡觉之后 夜间，40%-60%的抑郁症患者通常表现出一过性的 情绪改善，然后在午睡或第二天晚上就消失了 恢复睡眠。因此，睡眠剥夺范式成为一种 急性诱导情绪状态改变的非药物手段 这种方式可能会产生关于潜在机制的重要信息。 虽然情绪变化通常是短暂的，但它们可能会给人 对涉及情绪失调及其急性发作的神经系统的洞察 反转。一些患者表现出稳定的改善程度 剥夺睡眠，而另一些人表现出容忍，还有一些人表现出 睡眠剥夺诱导的情绪改善相对不稳定 在他们双相抑郁发作的早期，但易受短暂性 或在后来的过程中摆脱抑郁的长期转换 这一集。这些数据提供了一些第一批系统的观察结果 认为差异性神经生物学反应是 躁郁症发作的病程。初步数据显示 促甲状腺激素分泌的增加可能与 睡眠剥夺在我们的患者群体中的临床反应 整体研究，以及个别案例研究。学位较高的患者 睡前基准日的情绪日变化 与被剥夺者相比，剥夺者表现出更强的抗抑郁反应 无日变化的。

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.