A randomized, controlled trial assessing the acute efficacy of triple chronotherapy in unipolar depression

Yuen, Laura D.; Chen, Ying; Stewart, Jonathan W.; Arden, Peter C; Hellerstein, David J.

doi:10.1016/j.jad.2020.12.174

Cited by 8 publications

(7 citation statements)

References 22 publications

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“…Humpston et al [24] completed a meta-analysis of chronotherapy for unipolar and bipolar depression across 16 studies, finding treatment to be similarly effective for both conditions and superior to other types of therapy. Two RCTs have since been published, which further assessed the efficacy of triple chronotherapy for unipolar depression [84,85]. Yuen et al [84] conducted a small trial of triple chronotherapy in a sample of 44 outpatient adults with unipolar depression, finding remission rates 1 week out to be higher (25 vs. 7%) in those who received chronotherapy vs. an alternate protocol; however, results were not statistically significant possibly because of limited power.…”

Section: Treating Sleep Disturbance In Depressionmentioning

confidence: 99%

“…Two RCTs have since been published, which further assessed the efficacy of triple chronotherapy for unipolar depression [84,85]. Yuen et al [84] conducted a small trial of triple chronotherapy in a sample of 44 outpatient adults with unipolar depression, finding remission rates 1 week out to be higher (25 vs. 7%) in those who received chronotherapy vs. an alternate protocol; however, results were not statistically significant possibly because of limited power. In a slightly larger trial ( N = 82) of outpatient adults with depression, Veale et al [85] showed those randomized to triple chronotherapy showed a significant reduction in depression symptoms by 1 week after randomization – treatment effects which persisted through 26 weeks.…”

Section: Treating Sleep Disturbance In Depressionmentioning

confidence: 99%

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Recent advances in sleep and depression

Mirchandaney

Asarnow

Kaplan

2022

Current Opinion in Psychiatry

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Purpose of reviewThere is increasing interest in the connection between sleep disturbances and mood disorders. The purpose of this review is to summarize and evaluate current research on the role of sleep disturbance in the development of depression, as well as to describe recent advances in treatments that improve both sleep and depression symptoms. Recent findingsRelevant publications included in this review cover a wide range of topics related to sleep and depression. Data from large longitudinal studies suggest that insomnia and evening circadian preference are unique risk factors for depression. Depression treatment studies indicate poorer outcomes for those with comorbid sleep disturbances. A few recent trials of cognitive behavioral therapy for insomnia and triple chronotherapy in unipolar depression have shown promising results. SummarySleep disturbance is a modifiable risk factor in the development and maintenance of depression. In the context of current depression, although the data is mixed, some evidence suggests treating sleep disturbance can improve overall outcomes. Recent evidence also suggests that treating sleep disturbance may prevent the future depressive episodes.

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Section: Treating Sleep Disturbance In Depressionmentioning

confidence: 99%

Section: Treating Sleep Disturbance In Depressionmentioning

confidence: 99%

Recent advances in sleep and depression

Mirchandaney

Asarnow

Kaplan

2022

Current Opinion in Psychiatry

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“…and mild sleep/light management has been previously used (39,40,49). A short sleep hygiene consultation was chosen as control condition as it was in line with the pragmatic design of the study.…”

Section: Discussionmentioning

confidence: 99%

Total Sleep Deprivation Followed by Bright Light Therapy as Rapid Relief for Depression: A Pragmatic Randomized Controlled Trial

et al. 2021

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Background: Total sleep deprivation (TSD) combined with bright light therapy (BLT) has been suggested as a valuable add-on to standard treatment for rapid relief of depression. However, there is a lack of randomized controlled trials in real-life clinical settings. The aim of this pragmatic randomized clinical trial was to investigate the effectiveness, acceptance, and feasibility of TSD combined with BLT as add-on to standard treatment for depression in a real-life clinical setting.Methods: Thirty-three inpatients were randomly assigned to either: a) an intervention group receiving a single-night TSD followed by 6 days BLT (10.000 lux, 30 min/day) as add-on to standard treatment; or b) a control group receiving a short sleep-hygiene consultation in addition to standard treatment. The follow-up period was 1 week.Results: No statistical differences were found in response rates, reduction of depressive and insomnia symptoms, length of stay, readmission rate, and clinical improvement. Both groups reported positive experiences toward the received treatment with low drop-out rates.Conclusions: One-night TSD followed by BLT was not effective as a rapid relief for depression at 1-week follow-up; however, the treatment was feasible and well-tolerated.

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“…Wu et al 12 randomly allocated 49 outpatients with bipolar depression to TCT or medication and found that TCT yielded significantly better results both immediately after the SPA and at 7 weeks follow-up. Another trial of 44 unipolar depressed outpatients randomly allocated to TCT or an alternative protocol with fixed bedtimes and bright light without blue-green frequencies, failed to find significant differences after 1 week 9. However, there is a possibility that this trial was slightly underpowered as there were numerical tendencies towards TCT, and another trial of 82 unipolar depress participants from primary care in the UK, found significant differences between TCT and a control condition both after 1 week and at some of the longer-term assessments 10.…”

Section: Introductionmentioning

confidence: 99%

“…In inpatient settings, the use of three nights of TSD within a week, in addition to sleep-wake phase stabilisation and BLT has also been studied as a ‘TCT’ 8. However, TCT with a single night of TSD, followed by SPA and sleep-wake phase stabilisation and BLT, may arguably be more feasible for outpatient use7 and trials support its feasibility in these settings,9 10 though most trials of chronotherapy have been performed in inpatients 8 11…”

Section: Introductionmentioning

confidence: 99%

Chronotherapy for patients with a depressive episode treated in a public outpatient mental healthcare clinic in Norway: protocol for a randomised controlled trial

Ramfjord,

Kahn,

Langsrud

et al. 2024

BMJ Open

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IntroductionDepression is highly prevalent in outpatients receiving treatment for mental disorders. Treatment as usual (TAU) usually consists of either psychotherapy and/or antidepressant medication and often takes several weeks before clinical effect. Chronotherapy, consisting of sleep deprivation, sleep-wake phase advancement and stabilisation, and light therapy, is a possible addition to TAU that may decrease the time to treatment response. This randomised controlled trial will examine the benefits of adding chronotherapy to TAU compared with TAU alone.Methods and analysisThe trial will include 76 participants with a depressive episode who initiate outpatient treatment at a secondary mental healthcare outpatient clinic at St. Olavs University Hospital. Participants will be randomly allocated 1:1 to either chronotherapy in addition to TAU or TAU alone. Assessments will be performed at baseline, day 3, day 4, day 7, day 14 and weeks 4, 8, 24 and 52, in addition to longer-term follow ups. The main outcome is difference in levels of depressive symptoms after week 1 using the Inventory of Depressive Symptomatology Self-Report. Secondary outcomes include levels of depressive symptoms at other time points, as well as anxiety, health-related quality of life and sleep assessed through subjective and objective measures.Ethics and disseminationThe study protocol has been approved by the Regional Committee for Medical Research Ethics Central Norway (ref: 480812) and preregistered at ClinicalTrials.gov (ref:NCT05691647). Results will be published via peer-reviewed publications, presentations at research conferences and presentations for clinicians and other relevant groups. The main outcomes will be provided separately from exploratory analysis.Trial registration numberNCT05691647.

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A randomized, controlled trial assessing the acute efficacy of triple chronotherapy in unipolar depression

Cited by 8 publications

References 22 publications

Recent advances in sleep and depression

Recent advances in sleep and depression

Total Sleep Deprivation Followed by Bright Light Therapy as Rapid Relief for Depression: A Pragmatic Randomized Controlled Trial

Chronotherapy for patients with a depressive episode treated in a public outpatient mental healthcare clinic in Norway: protocol for a randomised controlled trial

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