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Chicago Psychiatry Associates define wake therapy as the use of prolonged periods of wakefulness, with intervening periods of recovery sleep, to induce rapid improvement in depressive symptoms.  They claim wake therapy ‘is best used as an antidepressant response inducer or accelerator; it jump starts the improvement in depression. When employed with other interventions, this antidepressant response can be maintained and solidified over months.’

stay-awake-all-nightVery interesting. Could wake therapy be a simple way to alleviate depression symptoms quickly when the blues descend and it feels impossible to do the other things that make us feel better?

Maybe staying awake all night would give us the impetus to re-start good habits, which would then start to make us feel better too.

Here’s a summary of the research evidence from Chicago Psychiatry Associates:

  • A rapid and clinically significant reduction in depressive symptoms occurs in between 50 to 60% of patients. This response typically occurs within hours. [Giedke and Schwarlzer, 2002;  Wu and Bunney, 1990 ]
  • It is not the absolute amount of sleep reduction that is important. Therapeutic effects mainly occur when sleep is prevented in the second half of the night. [Wirz-Justice and Van den Hoofdakker, 1999]
  • When combined with complementary chronotherapeutic (bright light therapy or sleep phase advance) or pharmacologic (antidepressants or mood stabilizers) interventions, wake therapy combinations produce sustained remissions that can last for months. [see various]
  • Wake therapy has a broad spectrum of antidepressant activity: it has been found to be effective in unipolar, bipolar, and melancholic types of depression. [Barbini et al, 1998]

The neurobiological mechanism for the anti-depressant effect of sleep deprivation is explored in this 2012 research paper Antidepressant effects of sleep deprivation require astrocyte-dependent adenosine mediated signaling. Good luck trying to understand that!

The treatment protocol for combined sleep deprivation and light therapy used by Chicago Psychiatry Associates (in conjunction with the Centre for Environmental Therapeutics, see previous post) can be found here.  In summary it involves one to three cycles (the night and entire following day) of complete sleep avoidance, separated by intervening nights of recovery sleep. The treatments vary between two to five days in duration depending on the number of cycles used. A combination of wake and bright light therapy is used along with sleep phase advance – termed triple chronotherapy. This treatment is a full, three-day process.

sleep deprivation/wake therapy

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