Sleep and manipulations of the sleep-wake rhythm in depression.
OBJECTIVE
Disturbed sleep is typical for most depressed patients and complaints about disordered sleep are the hallmarks of the disorder. Polysomnographic sleep research has demonstrated that besides impaired sleep continuity, sleep in depression is characterized by a reduction of slow wave sleep and a disinhibition of random eye movement (REM) sleep, with a shortening of REM latency, a prolongation of the first REM period and increased REM density.


METHODS
Our own experimental work has focused on the reciprocal interaction hypothesis of non-REM and REM sleep regulation as a model to explain the characteristic features of depressed sleep.


RESULTS
In agreement with the major tenet of this model, administration of cholinomimetics provoked shortened REM latency in healthy subjects and led to an even stronger REM sleep disinhibition in depressed patients. Manipulations of the sleep-wake cycle, such as sleep deprivation or a phase advance of the sleep period, alleviate depressive symptoms.


CONCLUSIONS
These data indicate a strong bidirectional relationship between sleep, sleep alterations and depression.
Berger
M
M
Department of Psychiatry and Psychotherapy, University Hospital of Freiburg, Germany.
van Calker
D
D
Riemann
D
D
D018678:Cholinergic Agents / Q000494:pharmacology*; D003866:Depressive Disorder / Q000209:etiology* / Q000628:therapy; D006801:Humans; D017286:Polysomnography; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000150:complications* / Q000523:psychology*; D012895:Sleep, REM / Q000187:drug effects*
D018678:Cholinergic Agents