Sleep Restriction Therapy & Depression

For most people, getting a good night's rest results in waking up refreshed and in a fairly decent mood. For those with unipolar depression, however, sleep restriction therapy---i.e., the withholding of sleep---may be more effective at keeping depressive symptoms at bay than getting plenty of pillow time.

Method

• Sleep restriction therapy is done easily in a sleep clinic or at home. It consists of little more than keeping oneself awake for half a night to a full night, or roughly an additional 4 to 8 hours.

Why It May Work

• The brain depends primarily on glucose to function properly. The level of glucose has to be just right or physical and cognitive function suffer. During sleep, some people with unipolar depression have elevated glucose levels. Glucose levels come down to normal levels after a sleep restriction therapy session, thereby theoretically relieving the depression symptoms. Additionally, those with depression sometimes exhibit longer primary rapid eye movement (REM) cycles with disturbances in the subsequent deeper stages of sleep. This may contribute to depression because the deep cycles of sleep are the cycles that are considered to be restorative for the brain; if the brain cannot recuperate, hormonal and other chemical balances may become off-kilter to the point of affecting mood negatively. Sleep deprivation tends to result in more restorative sleep and therefore may prevent this problem.

Effectiveness

• As many as half of those with unipolar depression may be helped by sleep restriction therapy. The effectiveness of the technique varies based on the specific study cited, however, so the effectiveness may be as low as 40 percent rather than 50 percent.

Problems

• Sleep restriction therapy works by forcing changes in the cerebral metabolism of the brain. When sleep occurs, there is no real way of maintaining changes in metabolism. The depression may reappear as soon as the patient rests enough.

Biological Depression vs. Non-biological Depression

• Those who may find sleep restriction therapy effective may have a biological problem that is related to their depressive symptoms. The therapy is probably not an effective treatment for depression that is the result of trauma or a situational/environmental problem. However, more research is needed in this area because depression itself can change the chemistry of the brain---if a person is depressed over their circumstances for a long enough period, this may well effect how their brain is metabolizing glucose.