Rapid Eye Movement Sleep Interruption as a Therapy for Major Depression

Abstract

Changes in rapid eye movement (REM) sleep and dreaming are some of the most popular issues in major depression. On the other hand, sleep deprivation studies showed that REM sleep deprivation is effective, at least partially, in treatment of mood disorders. Recent data suggest that sleep manipulations regarding REM sleep cause psychological/behavioral and neuroendocrine changes in depressed patients. In this chapter, first, I briefly present REM sleep abnormalities and dream variables in depression. Second, I review the consequences of REM sleep and dream manipulations in normal healthy subjects, in particular, in terms of diurnal rhythms. Finally, I discuss REM sleep and dream interruption as a therapy modality in depressive disorders. Rapid eye movement sleep abnormalities and dream variables in depression The main characteristics of REM sleep in depression are short sleep latency (<65 minutes), an increase in the number of eye movements per minute of sleep in the first REM sleep period (increased REM density), and a prolongation of the first REM episode [1]. These suggest a phase advance of the REM cycle in depression [2]. Clearly, these REM sleep signs are reported to correlate with the severity of the mood disorder [3]. On the other hand, Giles et al. [4] have reported concordance for shorter REM latency among family members who share the diagnosis of depression. This indicates a genetic propensity for depression indicated by the presence of this sleep sign. © Cambridge University Press 2010.