Swiss neurobiologist Anna Wirz-Justice, who previously treated a severely depressed patient, was an 80-year-old woman who for the first time prescribed "no sleep at night."
Anna said: "She used to sit there all day and felt like she was going to commit suicide, she barely spoke and rarely moved. ”
The prescription worked, and on the morning of the second day, the old woman spoke and walked around as if she had really changed into a person. ”
Anna said: "She told me that at about 2 or 3 a.m. she felt as if a dark cloud had risen from her shoulders. ”
Did Anna succeed? She and other researchers initially agreed that sleep deprivation would temporarily relieve depression.
A January 1990 review published in the American Journal of Psychiatry said that as many as 60 percent of people with depression experienced a 30 percent improvement after a night without sleep.
Those who felt most depressed in the morning and got better later seemed to benefit the most from a sleepless night.
But there's a problem: Once a good night's sleep, patients fall back into depression, and habitual sleep deprivation can trigger long-term health problems like high blood pressure and diabetes.
So by adjusting the wakeful cycle of sleep to find ways to alleviate depression.
First, use the power of hormones
Today, researchers are experimenting with how to use the body's circadian clock, circadian rhythm (or 24-hour rhythm) without letting patients give up rest altogether, and the solution may lie in choosing the time of sleep to benefit from the fluctuations of certain hormones throughout the day.
For example, thyroid-stimulating hormone (TSH) helps control the body's metabolism and thus indirectly controls our energy levels, and it is estimated that 25%-35% of depressed patients have lower TSH levels.
In recent years, researchers at the National Institute of Mental Health have found that sleep inhibits the release of TSH, while staying awake at night and early in the morning promotes the release of TSH.
Some researchers are trying to keep patients awake in the early morning for about a week to control the hormones that are surging in their bodies.
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Second, specific experiments
Doctors at the University Hospital in Freiburg, Germany, conducted the experiment on a group of depressed patients who felt better after a night of sleepless nights.
They had the patient go to bed at 5 p.m. and rest until midnight on the second night, for a total of 31 hours, after which the patient gradually returned to a normal sleep cycle within a week.
One night, they slept from 6 p.m. to 2 a.m., and on day 2 they slept from 7 p.m. to 3 a.m., until finally their sleep cycle returned to 11 p.m. to 6 a.m.
Notably, according to the findings published in the European Archives of Psychiatry and Clinical Neuroscience in the fall of 1999, the majority of patients (75%) had no recurrence of depression.
However, is such a scheme feasible?
Admittedly, such a protocol is difficult to follow, and Dr. Edward DeMet, who studies sleep deprivation at the Long Beach Veterans Affairs Medical Center, said patients only tried this sleep procedure under supervision, perhaps in a group to make the experience more enjoyable.
He said, "Obviously, if you need to drive on Day 2, well, you can't do that. ”
There are other ways to control sleep to improve depressive symptoms, for example, patients who don't sleep at night and are exposed to bright light in the morning appear to prolong the emotional benefits of this sleepless night.
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Sleep deprivation may be the most effective temporary way to help patients relieve symptoms
A study published by Anna and colleagues in the August 1999 issue of the journal Biopsychiatry showed that patients who tried sleep deprivation while taking antidepressants were also less likely to experience a recurrence of depression.
Because antidepressants such as fluoxetine or lithium often take several weeks to take effect, sleep deprivation may be the most effective temporary way to help patients relieve symptoms before the drug takes effect.
Anna, a professor in the Time Biology and Sleep Laboratory at the University Clinic of Psychiatry based in Basel, Switzerland, said: "It is much easier to take medicine in the morning than to stay up late, but sleep deprivation is very cheap and works very quickly, and for patients with severe depression, the experience of this day let them know that improvement is possible and they finally have hope." ”
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