Sleep deprivation can provide a short term cure of all symptoms of depression for as many as half of those that suffer from the mood disorder, new research claims.
It’s unclear what differentiates depressed people who respond to sleep deprivation and those that don’t.
The dramatic change to a depressed person’s sleep schedule acts as a kind of ‘reset’ to the internal circadian clock.
A University of Pennsylvania School of Medicine study found that once a patient goes back to sleep, however, their depression returns.
Get ready, get reset: Sleep deprivation may help to ‘reset’ the internal clock, for depressed people, whose Circadian rhythms are disrupted. A new study shows that skipping a night’s sleep be an effective short-term antidepressant for half of patients with the mood disorder
A ‘bizarre’ treatment for depression
Sleep deprivation seems to work as an antidepressant for 50 percent of patients regardless of several binaries that the study examined, including type of depression, type of sleep deprivation, and whether the patient was or was not taking an antidepressant medication.
Even a senior author, on the study, Dr Philip Gehrman, calls the antidepressant effects of sleep deprivation ‘bizarre.’
Scientists don’t know exactly how or why sleep deprivation works as an antidepressant.
The first report of the phenomenon dates all the way back to the 19th century.
Since 1990, more than 75 studies have been done using sleep deprivation to treat depression, but there hasn’t been a comprehensive analysis of these, so we haven’t known how conclusive or consistent the previous findings were.
The report, published in the Journal of Clinical Psychiatry, found that a consistent half of the patients in these studies responded well to sleep deprivation.
Which half of the population does it work for?
Dr Gehrman, an associate professor of Psychiatry and member of the Penn Sleep Center and clinical psychiatrist, said that the data on ‘who’ the responsive people and unresponsive people were are not conclusive. We don’t yet know what factors make someone a good candidate to be treated for sleep deprivation treatment of depression.
If sustained, sleep deprivation can lead to very serious health problems like heart disease or suicidal thoughts.
Pretty much everything about this antidepressant response is pretty paradoxical
Dr Philip Gehrman, University of Pennsylvania
Even getting insufficient sleep can contribute to both mental and physical health problems, including depression itself.
‘Pretty much everything about this antidepressant response is pretty paradoxical,’ Dr Gehrman says.
One night of sleep deprivation, while unpleasant, does not have any long term effects.
Sleep deprivation may help people to reset and rewire
Chief among these paradoxes is the effect of sleep deprivation on a depressed person’s circadian rhythms.
Circadian rhythms act like an internal clock regulating our waking and sleeping physical and mental functions.
People that struggle with depression have ‘disturbed daily circadian rhythms,’ Dr Gehrman says. Skipping a sleep cycle can act as a ‘reset’ of that internal clock, which might help to quell those disturbances, at least temporarily.
Scientists also suspect that sleep deprivation has a paradoxical effect on something called neuroplasticity in depressed people.
Get Rewired: Researchers think that sleep deprivation may stimulate neuroplasticity, or the brain’s ability to rewire itself. Depression impairs neuroplasticity, and better neuroplasticity improves a person’s chances of overcoming depression
The neuroplasticity of the brain determines its ability to form and change connections. This is ‘basically its ability to rewire itself,’ says Dr Gehrman.
People who suffer from depression are thought to have ‘impaired’ neurooplasticity,’ he says. The ability to rewire our brains can be instrumental in overcoming depression, especially through practices like cognitive behavioral therapy.
Research suggests that much of this ‘rewiring’ takes place during sleep. Though it seems like a contradiction, researchers thinks that isolated instances of sleep deprivation stimulate neuroplasticity.
So, Dr Gehrman thinks it is possible that sleep deprivation’s effect on neruroplasticity ‘reverses depression, in a short-lived manner.’
If it works, why don’t more people use sleep deprivation?
But sleep deprivation should be administered under the care of a professional, at an inpatient facility, which makes it expensive, and ‘labor intensive,’ says Dr Gehrman.
‘It’s a tough sell because to have someone in hosp over night. I don’t think too many insurance companies will be eager to pay for it.’
The study suggests that if done periodically as an augmentation to other treatment courses, like antidepressants or light exposure therapy, sleep deprivation could contribute to longer term improvements in patients with depression.
The average cost of a one-day inpatient hospital stay in the US varies depending on the type of hospital and the state it’s in, but the national average is around $2,000 per day, and patient’s often pay more than half of that.
The generic antidepressant bupropion costs around a dollar per 75 mg pill. For the moment, the cost of even one night of monitored sleep deprivation would still be greater than a whole year’s worth of antidepressant medication.
But, someday, if sleep deprivation therapy becomes better understood and more mainstream, ‘it might be that over the long term, it pays for itself,’ says Dr Gehrman.