The Neurobiological Mechanisms and Treatments of REM Sleep Disturbances in Depression

Abstract

Most depressed patients suffer from sleep abnormalities, which are one of the critical symptoms of depression. They are robust risk factors for the initiation and development of depression. Studies about sleep electroencephalograms have shown characteristic changes in depression such as reductions in non-rapid eye movement sleep production, disruptions of sleep continuity and disinhibition of rapid eye movement (REM) sleep. REM sleep alterations include a decrease in REM sleep latency, an increase in REM sleep duration and REM sleep density with respect to depressive episodes. Emotional brain processing dependent on the normal sleep-wake regulation seems to be failed in depression, which also promotes the development of clinical depression. Also, REM sleep alterations have been considered as biomarkers of depression. The disturbances of norepinephrine and serotonin systems may contribute to REM sleep abnormalities in depression. Lastly, this review also discusses the effects of different antidepressants on REM sleep disturbances in depression.

Opposite Impact of REM Sleep on Neurobehavioral Functioning in Children with Common Psychiatric Disorders Compared to Typically Developing Children

“…It is notable, however, that currently reported REM sleep alterations in children with a broad spectrum of psychiatric disorders correspond to findings in adults where psychiatric conditions such as depression, major depressive disorder, and post-traumatic stress disorder are featured by enhanced amounts of REM sleep (Benca et al, 1997; Wang et al, 2015; Baglioni et al, 2016). In adults, two parallel ways with a common source in the monoaminergic or cholinergic systems have been assumed to regulate both REM sleep and symptoms of depression (Wang et al, 2015). Likewise, we have proposed previously that altered aminergic-cholinergic ratio may lead to a REM sleep overdrive in the spectrum of developmental psychiatric conditions, as shown in the present study (Kirov et al, 2004, 2014; Brand and Kirov, 2011; Kirov and Brand, 2014).…”

“…Likewise, we have proposed previously that altered aminergic-cholinergic ratio may lead to a REM sleep overdrive in the spectrum of developmental psychiatric conditions, as shown in the present study (Kirov et al, 2004, 2014; Brand and Kirov, 2011; Kirov and Brand, 2014). Further, specific brain regions including the hippocampus, amygdala and medial pre-frontal cortex may contribute to both daily symptoms and REM sleep impairments in both depressive adults (Wang et al, 2015) and children with ADHD (Hart et al, 2013) While the precise neurobiological mechanisms of the co-existing deviations in daily behaviors and REM sleep remain to be established (Wang et al, 2015), our current findings on the relationships between REM sleep amount and daily behavior both in patients and healthy children may open a relevant new line of understanding by considering the contra-directionality of these relationships. If increased REM sleep amounts in children were expressions of co-impaired regulation of REM sleep and attention, increased REM sleep might not predict superior achievements in TDC.…”

Useful variables during wake and sleep for prediction of positive airway pressure in obstructive sleep apnea titration

“…OSA causes the reduction in REM sleep percentage. The more intense OSA, the shorter the length of REM (Kimoff, 1996;Wang et al, 2015).Therefore, a relative short REM can indicate an increase in the probability of need for BiPAP.…”

Dreamless: the silent epidemic of REM sleep loss

“…Psychopharmacological models that view dysregulated REM sleep as a cause of depression believe REM suppression is critical to the action of these drugs. 19 While selective serotonin reuptake inhibitors and their sister drugs suppress about one-third of REM/dreams, tricyclic antidepressants cut dreaming in half, and older monoamine oxidase inhibitors eliminate nearly all REM/dreaming. 20 Despite contradictory evidence, modern psychiatry generally clings to the notion that depression is linked to excessive and displaced dreaming.…”