Early versus late partial sleep deprivation in patients with premenstrual dysphoric disorder and normal comparison subjects

Abstract

These results are consistent with the reported efficacy of sleep deprivation for major depressive disorder. However, the premenstrual dysphoric disorder subjects improved after the recovery sleep rather than directly after partial sleep deprivation. That late-night sleep deprivation did not have greater benefit than did the hypothesized sham treatment, early-night sleep deprivation, also suggests that placebo effects cannot be ruled out.

Sleep, Hormones, and Circadian Rhythms throughout the Menstrual Cycle in Healthy Women and Women with Premenstrual Dysphoric Disorder

“…Decreased nocturnal melatonin secretion in PMS/PMDD has also been observed [62, 65]. Finally, nonpharmacological therapies for PMDD symptoms which target the sleep-wake cycle and circadian rhythms, such as phototherapy [110–112] and sleep deprivation [52, 65, 113, 114], are often effective in improving mood and sleep quality in these patients. …”

“…Total [113] and partial [114] sleep deprivation (SD) was also shown to be effective in reducing depressive symptoms in PMDD patients, with as many as 80% of patients responding to this treatment [113]. In a series of studies, Parry et al described the physiological effects of selective SD in PMDD patients [64, 68, 105].…”

Pilot Investigation of the Circadian Plasma Melatonin Rhythm across the Menstrual Cycle in a Small Group of Women with Premenstrual Dysphoric Disorder

“…Light therapy during LP significantly reduced depressive symptoms in PMDD women [15], [16], [17], with a response rate of up to 60% for either morning or evening bright light [17] and in 89% of menstrual cycles treated with evening bright light exposure [15]. PMDD women also respond to both total and partial sleep deprivation with improvements in mood [18], [19], as was observed in 80% of women with premenstrual depression after total sleep deprivation [18] and up to 67% of patients after early-night partial sleep deprivation [19].…”

Effects of Restricted Time in Bed on Antidepressant Treatment Response

“…Similarly, early studies showing that restricting wakefulness to the second half of the night (when REM sleep predominates) was more effective than so-called early PSD (i.e., staying awake until 1:30 and then initiating sleep) have since been challenged. 11,12,42 It is notable that the 8h TIB group was the only group to experience a reduction in slow wave sleep at Week 2 relative to baseline (4.0 ± 5.1% less). In a recent report, Landsness and colleagues 43 used acoustic stimuli to reduce slow wave sleep by 54% after one night relative to baseline (without reducing total sleep time) in 17 non-medicated depressed adults.…”

“…Wakefulness during the second half of the night (late PSD, when rapid eye movement [REM] sleep predominates) is often superior to wakefulness in the first half (early PSD), 10 but perhaps not if total sleep time is equivalent. 11,12 Repetition of PSD during the initial 1–4 weeks of antidepressant therapy can accelerate treatment response 13–15 and quality of life improvement, 16 but these studies were conducted inpatient or in a laboratory setting and did not include sleep control conditions or sufficient follow-up after the PSD procedures. Ideal sleep-focused strategies would be clinically efficacious and maximize patient feasibility by allowing treatments to be carried out safely in the home environment.…”