REM sleep in depression—an overview
Open Access
- 1 December 1993
- journal article
- Published by Wiley in Journal of Sleep Research
- Vol. 2 (4), 211-223
- https://doi.org/10.1111/j.1365-2869.1993.tb00092.x
Abstract
SUMMARY Abnormalities of REM sleep, i.e. shortening of REM latency, lengthening of the duration of the first REM period and heightening of REM density, which are frequently observed in patients with a major depressive disorder (MDD), have attracted considerable interest. Initial hopes that these aberrant patterns of sleep constitute specific markers for the primary/endogenous sub‐type of depression have not been fulfilled. The specificity of REM sleep disinhibition for depression in comparison with other psychopathological groups is challenged as well. Demographic variables like age and sex exert strong influences on sleep physiology and must be controlled when searching for specific markers of depressed sleep. It is still an open question whether abnormalities of sleep are state‐ or trait‐markers of depression. Beyond baseline studies, the cholinergic REM induction test (CRIT) indicated a heightened responsitivity of the REM sleep system to cholinergic challenge in depression compared with healthy controls and other psychopathological groups, with the exception of schizophrenia. A special role for REM sleep in depression is supported by the well‐known REM sleep suppressing effect of most antidepressants. The antidepressant effect of selective REM deprivation by awakenings stresses the importance of mechanisms involved in REM sleep regulation for the understanding of the pathophysiology of depressive disorders. The positive effect of total sleep deprivation on depressive mood which can be reversed by daytime naps, furthermore emphasizes relationships between sleep and depression. Experimental evidence as described above instigated several theories like the REM deprivation hypothesis, the 2‐process model and the reciprocal interaction model of nonREM‐REM sleep regulation to explain the deviant sleep pattern of depression. The different models will be discussed with reference to empirical data gathered in the field.Keywords
This publication has 125 references indexed in Scilit:
- REM sleep in successful, usual, and pathological aging: the Pittsburgh experience 1980–1993Journal of Sleep Research, 1993
- 48-hour rapid cycling: results of psychopathometric, polysomnographic, PET imaging and neuro-endocrine longitudinal investigations in a single caseJournal of Affective Disorders, 1993
- The sleep structure of patients with anxiety disorders in comparison to that of healthy controls and depressive patients under baseline conditions and after cholinergic stimulationJournal of Affective Disorders, 1992
- REM-Suppressing Effects of Amitriptyline and Amitriptyline-N-Oxide After Acute Medication in Healthy Volunteers: Results of Two Uncontrolled Pilot TrialsPharmacopsychiatry, 1990
- On the contribution of sleep wake physiology to the explanation and the treatment of depressionActa Psychiatrica Scandinavica, 1988
- Shortened REM Latency: Consequence of Psychological Strain?Psychophysiology, 1987
- Cimoxaton and Moclobemid, Two New MAO-lnhibitors:Influence on Sleep Parameters in Patients with Major Depressive DisorderPharmacopsychiatry, 1986
- The Effect of Trimipramine on Sleep in Patients with Major Depressive DisorderPharmacopsychiatry, 1986
- REM Sleep Induction by Physostigmine Infusion During SleepScience, 1976
- Sleep Cycle Oscillation: Reciprocal Discharge by Two Brainstem Neuronal GroupsScience, 1975