Depressions
The so-called sleep deprivation or awake therapy refers to the controlled reduction of night sleep in a therapeutic setting under medical supervision, e.g. during an inpatient stay in hospital. It can be used to treat depression, but is not an independent form of therapy. It should be used in conjunction with psychotherapy and drug therapy.
A particular weakness is the high workload for the nursing staff. Furthermore, it is used as an additional therapy option when there is a depression for which all other means of treatment have been exhausted or when the duration of action of the antidepressants has decreased. Furthermore, it can be used to determine the difference between depressive pseudodementia and actual dementia.
Depressive people often do not even get tired in circumstances where other, healthy people fall asleep. Their brain is running at full speed and they may feel dull and tired, but they are not. A study comparing brain waves of depressed, healthy and manic people concluded that people with a highly increased drive fall asleep more quickly in a boring or unattractive environment, while depressives have difficulty finding sleep.
Awake therapy interrupts the disturbed sleep rhythms and in the best case, the regulation of sleep is favourably influenced. There is also evidence that morning sleep cycles in particular can increase depression. The patients are kept awake in groups and distracted by activities.
Either the whole night, or, if it is a partial (i.e. partial) sleep deprivation, sleep is shortened in the early morning hours.However, the positive effect of sleep deprivation usually lasts only for one day, which is a disadvantage because you cannot go without sleep for a longer period of time without negative consequences that may be worse than depression. By shifting the sleeping phases, however, one can counteract this and maintain the positive effect. A misalignment of the sleep phases takes place temporally seen forward, since, as discussed above, in particular the sleep portions in the morning can strengthen the symptoms of the depression.
The patient goes on the day after the sleep deprivation consequently earlier into the bed and rises after a sufficient sleep quantity also again in former times. This process is repeated and shifted further and further back in time (i.e. you go to bed later and later) until the patient is back to his normal sleeping hours. Side effects of sleep deprivation therapy can be manic states, an increase in symptoms or an increase in drive. Especially in the latter case, caution is advised as this can increase the risk of suicide.
