Sleep at baseline and after electroconvulsive therapy in patients with major depression.
Sleep in major depressive disorder is frequently altered and possibly indicative for treatment outcomes. For example, increased rapid eye movement (REM-) sleep density seems to predict worse treatment outcomes of psychotherapy. We therefore investigated pre-treatment sleep and sleep changes after termination of electroconvulsive therapy (ECT). Sleep was polysomnographically recorded. The analysed sample consisted of 15 inpatients with ages ranging from 30 to 80 (mean 59 years). ECT was applied two times a week up to 7 weeks. Stable remission of depressive symptoms was defined by a score in the Hamilton Rating Scale of Depression <8 at six months after ECT. The main results were an increase in sleep efficiency and a decrease in the number of awakenings within the course of ECT in the entire patient group. Significant increases in slow wave sleep and REM sleep duration and a significant decrease in REM density were only seen in stable remitters and not in non-remitters. In pre-treatment baseline sleep a higher REM density of the first REM sleep period was significantly associated with better ECT outcome. In conclusion, REM density of the first REM sleep period seems to be an interesting candidate as putative predictor of stable treatment outcome of ECT.
Department of Psychiatry and Psychotherapy, Christian-Albrecht-University/University Hospital, Campus Kiel, Schleswig-Holstein, Germany. Electronic address: robert.goeder@uksh.de.
Robert
R
Göder
Department of Psychiatry and Psychotherapy, Christian-Albrecht-University/University Hospital, Campus Kiel, Schleswig-Holstein, Germany.
Irina
I
Hinrichsen
Department of Psychiatry and Psychotherapy, Christian-Albrecht-University/University Hospital, Campus Kiel, Schleswig-Holstein, Germany.
Mareen
M
Seeck-Hirschner
Department of Psychiatry and Psychotherapy, Christian-Albrecht-University/University Hospital, Campus Kiel, Schleswig-Holstein, Germany.
Richard
R
Pfeiffer
Department of Psychiatry and Psychotherapy, Christian-Albrecht-University/University Hospital, Campus Kiel, Schleswig-Holstein, Germany.
Sara Lena
SL
Weinhold
Department of Psychiatry and Psychotherapy, Christian-Albrecht-University/University Hospital, Campus Kiel, Schleswig-Holstein, Germany.
Paul Christian
PC
Baier
Department of Anaesthesiology, Christian-Albrecht-University/University Hospital, Campus Kiel, Schleswig-Holstein, Germany.
Robert
R
Hanss
Department of Psychiatry and Psychotherapy, Christian-Albrecht-University/University Hospital, Campus Kiel, Schleswig-Holstein, Germany.
Christina
C
Schulz-DuBois
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003865:Major Depressive Disorder / Q000150:complications / Q000628:therapy*; D004565:Electroconvulsive Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012074:Remission Induction; D012893:Sleep Wake Disorders / Q000209:etiology / Q000628:therapy*; D012895:Sleep, REM / Q000502:physiology*; D016896:Treatment Outcome
ECT; Major depression; Polysomnography; REM sleep density