Skip to main content Accessibility help
×
Hostname: page-component-586b7cd67f-gb8f7 Total loading time: 0 Render date: 2024-11-22T18:31:02.749Z Has data issue: false hasContentIssue false

5 - Sleep abnormalities in treatment-resistant mood disorders

from Part II - Biological basis

Published online by Cambridge University Press:  25 March 2010

Jay D. Amsterdam
Affiliation:
University of Pennsylvania
Mady Hornig
Affiliation:
University of California, Irvine
Andrew A. Nierenberg
Affiliation:
Harvard Medical School
Get access

Summary

Oh Sleep! It is a gentle thing,

Beloved from pole to pole …

Samuel Taylor Coleridge

The close inter-relationship between mood and sleep, has led some to suggest that sleep-wake cycle alterations are central to these disorders (Goodwin & Jamieson, 1990). In this chapter, we will review the existing literature on the relationship between sleep and mood disorders, in particular, treatment-resistant disorders.

  1. (i) We will begin by reviewing the subjective and objective changes in sleep that occur in depressive and manic episodes and describe how these sleep findings may be predictive of treatment-resistant states.

  2. (ii) We will then go on to describe the various manipulations, either deliberate or accidental, of the sleep–wake cycle which can either improve treatment-resistant depressive states, or conversely, contribute to treatment-resistant manic states.

  3. (iii) We will then discuss the relationship between primary sleep disorders and treatment-resistant mood states.

Normal Sleep

Normal sleep consists of alternating REM (rapid eye movement) and non-REM epochs. Non-REM sleep is divided into four stages. During Stages 1 and 2, individuals are easily awakened and can be partially aware of environmental events, such as someone entering the room. Thus, a person in these shallower stages, though asleep, may experience himself or herself as being awake. In contrast, the arousal threshold for Stages 3 and 4 (delta) sleep is much higher. Data suggest that this deeper sleep is the restorative period of the sleep cycle. Thus, in the absence of adequate delta sleep, one awakens feeling tired and unrefreshed.

The electroencephalographic characteristics of REM sleep bears similarities to Stage 1 and the waking stage, being predominated by low voltage, fast activity.

Type
Chapter
Information
Publisher: Cambridge University Press
Print publication year: 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×