Sleep deprivation combined with consecutive sleep phase advance as a fast-acting therapy in depression: an open pilot trial in medicated and unmedicated patients

Am J Psychiatry. 1997 Jun;154(6):870-2. doi: 10.1176/ajp.154.6.870.


Objective: The authors' goal was to test the hypothesis that the antidepressant effect of total sleep deprivation can be maintained by initially avoiding sleep during a supposedly "critical" time period in the early morning.

Method: They studied 33 inpatients with major depression, melancholic type, all of whom responded positively to total sleep deprivation. Twelve of the patients were men and 21 were women; their mean age was 46.7 years (SD = 13.7). After total sleep deprivation, the patients started a sleep schedule from 5:00 p.m. to 12:00 midnight, which then was shifted back by 1 hour each day until a sleep time of 11:00 p.m. to 6:00 a.m. was reached.

Results: Twenty (61%) of the 33 patients who responded to total sleep deprivation with an improved state of mood maintained this improvement during sleep phase advance therapy. Drug-free and medicated patients did not differ from each other.

Conclusions: The rapid amelioration of mood observed with total sleep deprivation can be preserved with a succeeding phase shift of the sleep period.

Publication types

  • Clinical Trial
  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antidepressive Agents / therapeutic use*
  • Circadian Rhythm*
  • Combined Modality Therapy
  • Depressive Disorder / drug therapy
  • Depressive Disorder / psychology
  • Depressive Disorder / therapy*
  • Female
  • Hospitalization
  • Humans
  • Male
  • Middle Aged
  • Pilot Projects
  • Sleep Deprivation*
  • Sleep Stages
  • Sleep*
  • Treatment Outcome


  • Antidepressive Agents