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Resetting the Sleep Clock Could Decrease Symptoms of Depression

 

Individuals with depression often experience disrupted sleep patterns. This change in sleep structure can exacerbate the symptoms of depression, increasing fatigue and negative affect. When deprived of sleep, certain neurotransmitters are more active, producing more dopamine, serotonin, and norepinephrine. Additionally, deprivation can affect the metabolism within the brain. Chronotherapy is a technique that involves manipulation of sleep patterns in an effort to improve psychiatric symptoms. Using sleep deprivation and forced-sleep sessions, chronotherapy strives to reset the sleep clock that is so impaired by depression. In a recent study, Michael I. Casher, M.D., Clinical Assistant Professor of Psychiatry at the University of Michigan Medical School, evaluated two women who underwent chronotherapy for depression while receiving inpatient care.

The two young adult subjects had significant depressive histories with comorbid conditions that impaired their ability to respond to treatment. After chronotherapy was conducted, both women saw improved symptoms and significant reductions in depression. Sleep patterns improved for both women, and the second subject also had additional light therapy in conjunction with the chronotherapy. Her results were maintained when Casher evaluated her 7 weeks posttreatment. Both of the subjects were also receiving antidepressant medication at the time of the chronotherapy.

Inpatient facilities are under enormous pressure to provide immediate results. Medication protocols often fall short of expeditious improvement in significantly depressed individuals. Therefore, providing additional therapies in combination with medication may meet the needs of the clinicians and the patients in the most affordable, effective, and nonintrusive way. Casher believes that chronotherapy is one such approach. He added, “Additional benefits that have been reported include cost-effectiveness, tolerability, and reduced inpatient hospital days.” Overall, chronotherapy should be considered as a viable method of reducing depressive symptoms in individuals being treated with more traditional approaches, such as light therapy and medication. Additionally, chronotherapy could significantly reduce the duration of inpatient stays for individuals admitted for depression and should be explored as a way to achieve swift and sustainable results in hospital settings.

Reference:
Casher, M. I., Schuldt, S., Haq, A., Burkhead-Weiner, D. (2012). Chronotherapy in treatment-resistant depression. Psychiatric Annals, 42.5, 166-169.

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Comments
  • Drew June 7th, 2012 at 11:25 AM #1

    While it must be pretty difficult to actually reset that clock, what with the periods of forced sleep and then deprivation, I see how this could in the end be something positive for the patient with depression.

    When you are depressed, you’re right. The sleep patterns get all out of whack and when that happens it’s no wonder that you don’t have any energy. Either you are spacy from a lack of sleep or comatose from too much sleep!

    While at first it seemed like it would be crazy to put someone who is already hurting through this kind of treatment, I really feel like a lot of people, if they can tough it out, could truly benefit from this.

  • Charlene P June 7th, 2012 at 1:10 PM #2

    How young were the subjects?
    Do you think that age had anything to do with how well they responded to this sort of treatment?
    Not everyone of just any age could withstand the pressures of lack of sleep like maybe they could.

  • Susan Bruhn June 8th, 2012 at 3:25 AM #3

    There are terms that I could not understand very well. Why is it that my brother wakes up so early if there’s no class? But if there’s a class, it’s hard for him to get up.

  • Hank June 8th, 2012 at 4:31 AM #4

    I have always been a person who has had my internal clock all mixed up. My mom says that it all started when I was a baby and wanted to sleep all day and stay up all night. I have never gotten past that, but I have never had a problem with depression either. I am the perfect third shift worker becauseI guess I get the right amount of sleep in terms of hours but just at a different time of day that most people do.

  • Dominique June 8th, 2012 at 2:46 PM #5

    i have never heard of this chronotherapy- is it widely available?

  • Bella T June 9th, 2012 at 7:02 AM #6

    Along with my regular therapy I have bought a light therapy machine as my depression seems to worsen seasonally. This has worked very well for me, and I encourage others to try this if they have the same sort of depression that I do. I feel so much better after both my sessions with my therapist and the light therapy apparatus.

  • Jake June 10th, 2012 at 8:42 AM #7

    You state that inpatient facilities are feeling the pressure to provide immediate results.
    Why is that? Who is mandating that results be quick?
    Probably the insurance companies when they are picking up the tab, or family members who could be footing the bill.
    I would rather the treatment be slow and contemplative giving the patient a real chance for success, not just a fast and easy solution.

  • psych June 11th, 2012 at 12:48 AM #8

    I definitely agree that depression creates a chaotic sleeping patterns. But I’ll buy the idea that resetting my routine sleeping clock would reduce the anxiety. This helps!

  • savannah s June 11th, 2012 at 5:22 PM #9

    I would think that for this to be the most successful you would have to perform this chronotherapy in a setting where the patient really could not know the difference between night and day. How could it ever be a success if they can see out and know what time it really is. I am also curious if doing this has to emply the use of sleep medications like Ambien, because I would think that the clinicians would want the patients to be able to regulate the sleep on their own and not through the use of more meds.

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