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Privation de sommeil dans la dépression

Published online by Cambridge University Press:  28 April 2020

D. Pringuey
D. Pringuey*
Affiliation:
Service du Pr G. Darcourt, CHRU de Nice, Pavillon J, Hôpital Pasteur, BP 69, 06002Nice Cedex, France
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Résumé

Bien que la maladie dépressive se manifeste par des troubles majeurs du sommeil, reposant sur une désorganisation architecturale assez spécifique, la privation totale du sommeil (DTS) d’une nuit apporte un allègement symptomatique notable le plus souvent immédiat, contemporain de la privation.

A la suite des observations fortuites de Schulte, des séries systématiques et contrôlées ont défini le cadre et les limites de l’efficacité de la PTS et diverses investigations biologiques ont cherché à identifier des variables prédictives de son activité.

La PTS apporte une amélioration dans environ 60% des cas, plus régulièrement dans les formes endogènes et lorsqu’il y a des variations diurnes de l’humeur. Cette amélioration est globale et elle apparaît le plus souvent aux heures de l’aube mais elle est transitoire, le bénéfice étant perdu au lendemain de la nuit de récupération d’où la nécessité de répéter la privation ou d’y associer une chimiothérapie antidépressive.

Les investigations neurobiologiques situent la réponse clinique en rapport avec diverses modifications sur les paramétres catécholaminergiques et neuro-endocriniens ainsi que sur la structuration du sommeil.

L’activation thymique se corrèle avec une facilité relative à maintenir l’éveil et se manifeste à un horaire particulier qui correspond à une époque circadienne critique. La PTS produirait une réorganisation des rapports entre la veille et le sommeil et parviendrait à rétablir les coïncidences de phases des rythmes biologiques. Ces données apportent une contribution nouvelle à la notion spécifique d’instabilité dépressive.

Summary

Summary

Major sleep disturbances are the most common symptoms in depressive disorders, but a single night sleep deprivation (total sleep deprivation, TSD) produces an early improvernent, beginning during the procedure.

Since the initial reports by Schulte, controlled trials stated the conditions of response to TSD and assessed a number of predictive biological correlates.

The beneficial effects occur in 60% patients, more frequently in endogenous depression and when diurnal mood swings are marked. An overall clinical improvement is observed, particularly in the first hours of the day. Responders often relapse following the recovery sleep, therefore the procedure needs to be repeated and combined with antidepressants.

Neurobiological studies have shown that the response correlates with changes in catecholamine metabolism, neuro-endocrine patterns and EEG sleep measures.

The mood-activating effect of TSD is correlated with the ability of the patients to remain awake; the onset of mood changes occurs in certain time lapses. TSD regulates relationships between sleep and wake States and hypothetically favours phase coincidences between several biological rhythms. These data underline the role of biological instability as a pathogenetical core in depression.

Keywords

Privation totale de sommeildépression endogènerythmes biologiquestotal sleep deprivationendogenous depressive disordersbiological rhythms
Type
Article original
Information
Psychiatry and Psychobiology , Volume 3 , Issue 6 , 1988 , pp. 419 - 426
Copyright
Copyright © European Psychiatric Association 1988

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References

Références

Amin, M. (1978) Response to sleep deprivation and therapeutic results with antidepressant. Lancet 2, 165CrossRefGoogle Scholar
Amin, M.M.Khalid, R. & Khan, P. (1980) Relationship between sleep deprivation and urinary MHPG levels. Int. Pharmacopsychiatry 15, 81–85CrossRefGoogle ScholarPubMed
Bhanji, S. & Roy, G.A. (1975) The treatment of psychotic depression by sleep deprivation: a replication study. Br. J. Psychiatry 127, 222–226CrossRefGoogle ScholarPubMed
Bhanji, S.Roy, G.A. & Baulieu, C. (1978) Analysis of mood change during and following sleep deprivation therapy. Acta Psychiatr. Scand. 58, 379–383CrossRefGoogle ScholarPubMed
Borbely, A.A. (1982) A two process model of sleep regulation. Hum. Neurobiol. 1, 195–204Google ScholarPubMed
Buddeberg, C. & Dittrich, A. (1978) Psychologische Aspekte des Schlafentzuges. Arch. Psychiatr. Nervenkr. 225, 249–266CrossRefGoogle Scholar
Christodolou, G.N.Malliaras, D.E.Lykouras, E.P.Papadimitriou, G.N.B. & Stefanis, C.N. (1978) Possible prophylactic effect of sleep deprivation. Am. J. Psychiatry 135, 375–376Google Scholar
Gole, M.G. & Mueller, H.F. (1976) Sleep deprivation in the treatment of elderly depressed patients. J. Am. Geriatr. Soc. 24, 308–313Google Scholar
Duncan, W.C.Gillin, J.C.Post, R.M.Gerner, R.H. & Wehr, T.A. (1980) Relationship between sleep patterns and clinical improvement in depressed patients treated with sleep deprivation. Biol. Psychiatry 15, 879–890Google ScholarPubMed
Fahndrich, E. (1981) Effects of sleep deprivation on depressed patients of different nosological groups. Psychiatry Res. 5, 277–285CrossRefGoogle ScholarPubMed
Gerner, R.H.Post, R.M.Gillin, J.C. & Bunney, W.E. Jr (1979) Biological and behavioral effects of one night's sleep deprivation in depressed patients and normals. J. Psychiatr. Res. 15, 21–40CrossRefGoogle ScholarPubMed
Gilberg, M. & Akerstedt, T. (1981) Sleep deprivation in normals-some psychological and biochemical data from those studies. In: Sleep 1980 (Koella, W.P., ed.), Karger, Basel, pp. 16–22Google Scholar
Gillin, J.C.Duncan, W.C.Pettigrew, K.D.Frankel, B.L. & Snyder, F. (1975) Successful separation of depressed, normal and insomniac subjects by EEG sleep data. Arch. Gen. Psychiatry 36, 85–90CrossRefGoogle Scholar
Jimerson, D.C.Lynch, H.J.Post, R.M.Wurtman, R.J. & Bunney, W.E. Jr (1977) Urinary melatonin rhythms during sleep deprivation in depressed patients and normals. Life Sci. 20, 1501–1508CrossRefGoogle ScholarPubMed
King, D.Dowdy, S.Jack, R.Gardner, R. & Edwards, P. (1982) The dexamethasone suppression test as a predictor of sleep deprivation antidepressant effect. Psychiatry Res. 7, 93–99CrossRefGoogle ScholarPubMed
Knowles, J.G.Southmayd, S.E.Delva, N.MacLean, A.W.Cairns, J. & Lebemendia, F.J. (1979) Five variations of sleep deprivation in a depressed woman. Br. J. Psychiatry 135, 403–410CrossRefGoogle Scholar
Kretschmar, J.H. & Peters, U.H. (1973) Schlafentzug zur Behandlung endogener Depression. In: The Nature of Sleep (Jovoric, U.T., ed.), Fischer, StuttgartGoogle Scholar
Kvist, J. & Kirkegaard, C. (1980) Effect of repeated sleep deprivation on clinical symptoms and the TRH test in endogenous depression. Acta Psychiatr. Scand. 62, 494–502CrossRefGoogle ScholarPubMed
Larsen, I.K.Lindberg, M.L. & Skovgaard, B. (1976) Sleep deprivation as treatment for endogenous depression. Acta Psychiatr. Scand. 54, 167–173CrossRefGoogle ScholarPubMed
Lit, A.C. (1973) Electroschok en slaaponthonding. Tijdschr. Psychiatr. 2, 56Google Scholar
Livrea, P.Direda, L.Puca, F.M.Genco, S.Specchio, L.M. & Papagno, G. (1977) Homovanillic acid and 5-hydroxyindoleacetic acid in lumbar cerebrospinal fluid after total and REM sleep deprivation in humans. Eur. Neurol. 16, 280–285CrossRefGoogle ScholarPubMed
Loosen, P.T.Merkel, V. & Amelung, V. (1976) Combined sleep therapy and treatment for endogenous depression. Lancet 2, 156—157CrossRefGoogle Scholar
Lovett Dourst, J.W. & Christie, H. (1980) Repeated sleep deprivation as a therapeutic Zeitgeber tor circular type manic depressive disturbance. Chronobiologia 1 (4), 505–511Google Scholar
Matussek, N.Ackenheil, M.Athen, D.Beckman, H.Benkert, O.Dittmer, T.Hippins, H.Loosen, P.Ruther, E. & Scheller, M. (1974) Catecholamine metabolism under sleep deprivation therapy of improved and not improved depressed patients. Pharmakopsychiatr. Neuro-Psychopharmakol. 7, 108–114CrossRefGoogle Scholar
Matussek, N.Romisch, P. & Ackenheil, M. (1977) MHPG excretion during sleep deprivation in endogenous depression. Neuropsychobiology 3, 23–29CrossRefGoogle ScholarPubMed
Nasrallah, H.A.Kuperman, S. & Coryell, W. (1980) Reversal of dexamethasone nonsuppression with sleep deprivation in primary depression. Am. J. Psychiatry 137, 1462–1464Google ScholarPubMed
Nasrallah, H.A. & Coryell, W.H. (1982) Dexamethasone nonsuppression predicts the anti-depressant effects of sleep deprivation. Psychiatry Res. 6, 61–64CrossRefGoogle Scholar
Palmblad, J.Akerstedt, T.Froberg, J.Melander, A. & Von Schenck, H (1979) Thyroid and adrenomedullary reactions during sleep deprivation. Acta Endocrinol. 90, 233–239CrossRefGoogle ScholarPubMed
Papadimitriou, G.N.Christodoulou, G.N.Trikkas, G.M.Malliaras, D.E.Lykouras, E.P. & Stefanis, C.N. (1981) Sleep deprivation psychoprophylaxis in recurrent affective disorders. Bibl. Psychiatr. 160, 56–61Google Scholar
Papousek, M. (1975) Chronobiologische Aspekte der Zyklothymie. Fortschr. Neurol. Psychiatr. Grenzgeb. 43, 381–440Google Scholar
Pflug, B. & Tolle, R. (1971a) Therapie endogener Depressionen durch Schlafentzug - praktische und theoretische Konsequenzen. Nervenarzt 42, 117–124Google Scholar
Pflug, B. & Tolle, R. (1971b) Disturbance of the 24-hour-rhythm in endogenous depression and the treatment of endogenous depression by sleep deprivation. Int. Pharmacopsychiatry 6, 187–196CrossRefGoogle Scholar
Pflug, B. (1972) Über den Schlafentzug in der ambulanten Therapie endogener Depression. Nervenartz 43, 614–622Google Scholar
Pflug, B. (1976) The effect of sleep deprivation on depressed patients. Acta Psychiatr. Scand. 53, 143–158CrossRefGoogle ScholarPubMed
Pflug, B.Johnsson, A. & Treito Ekse, A. (1981) Manicdepressive States and daily temperature. Acta Psychiatr. Scand. 63, 277—289CrossRefGoogle Scholar
Philipp, M. (1978) Depressions Verlauf nach Schlafentzug. Nervenarzt 49, 120–123Google Scholar
Post, R.M.Stoddard, F.J.Gillin, J.C.Buchsbaum, M.S.Runkle, D.C.Black, K.E. & Bunney, W.E. Jr (1977) Alterations in motor activity, sleep and biochemistry in a cycling manic-depressive patient. Arch. Gen. Psychiatry 34, 470–477CrossRefGoogle Scholar
Pringuey, D. (1979) Aspects chronobiologiques de la maladie maniaque dépressive. Actual. Psychiatr. 6, 95–104Google Scholar
Reynolds, C.F.Kupfer, D.J. & Hoch, C.C. (1987) Sleep deprivation as a probe in the elderly. Arch. Gen. Psychiatry 44 (11), 982–990CrossRefGoogle ScholarPubMed
Roy-Byrne, P.P.Uhde, T.W. & Post, R.M. (1984) Antidepressant effects of one night's sleep deprivation. In: Neurobiology of Mood Disorders (Post, R.M. and Ballenger, J.C., eds), Williams and Wilkins, Baltimore, p. 817–825Google Scholar
Rudolf, G.A. & Tolle, R. (1978a) Sleep deprivation and circadian rhythm in depression. Psychiatr. Clin. (Basel) 11, 198–212Google Scholar
Rudolf, G.A. & Tolle, R. (1978b) The course of the night with total sleep deprivation as antidepressant therapy. Waking Sleeping 2, 83–91Google Scholar
Schilgen, V.B.Bischofs, W.Blaszkiewicz, F.Bremer, W.Rudolf, G.A.E. & Tolle, R. (1976) Totaler und partieller Schlafentzug in der Behandlung von Depressionen. Arzneim.-Forsch. 26, 1171–1173Google Scholar
Schmocker, M.Baumann, P.Reyero, F. & Heimann, H. (1975) Der Schlafentzug. Eine klinische, psychophysiologische und biochemische Untersuchung. Arch. Psychiatr. Nervenk. 221 (2), 111–122CrossRefGoogle Scholar
Schulte, W. (1971) Zum Problem der Provokation und Kupierung von melancholischen Phasen. Schweiz. Arch. Neurol. Neurochir. Psychiatr. 109, 427–435Google Scholar
Svendsen, K. (1976) Sleep deprivation therapy in depression. Acta Psychiatr. Scand. 54, 184–192CrossRefGoogle ScholarPubMed
Uhde, T.W.Post, R.M.Ballenger, J.C.Cutler, N.R.Jimerson, D.C.Weitzman, E.D. & Bunney, W.E. Jr (1981) Circadian rhythm and sleep deprivation in depression. In: Sleep 1980, (Koella, W.P., ed.), Karger, Basel, pp. 23–26Google Scholar
Van Bemmel, A.L. & Van Den Hoofdakker, R.H. (1981) Maintenance of therapeutic effects of total sleep deprivation by limitation of subsequent sleep. Acta Psychiatr. Scand. 63, 453–462CrossRefGoogle ScholarPubMed
Van Den Burg, W. & Van Den Hoofdakker, R.H. (1975) Total sleep deprivation on endogenous depression. Arch. Gen. Psychiatry 32, 1121–1125CrossRefGoogle ScholarPubMed
Van Den Hoofdakker, R.H. & Elsinga, S. (1981) Clinical effects of sleep deprivation in endogenous depression. In: Sleep 1980, (Koella, W.P., ed.), Karger, Basel, pp. 1–9Google Scholar
Van Scheyen, J.D. (1977) Slaapdeprivatie biz de behandeling van unipolaire (endogene) vitale depressies. Ned. Tijdschr. Geneeskd. 121, 564–571Google Scholar
Voss, A. & Kind, H. (1974) Ambulante Behandlung endogener Depression durch Schlafentzug. Schweiz. Rundsch. Med. Prax. 63, 564–569Google Scholar
Waldmann von, K.D.Hass, S. & Greger, J. (1979) Schlafentzug in der Therapie endogener Depressionen. Dtsch. Gesundheitswesen. 34, 2419–2421Google Scholar
Wehr, T.A.Wirz-Justice, A.Goodwin, F.K.Ducan, W. & Gillin, J.C. (1979) Phase advance of the sleepwake cycle as an antidepressant. Science 206, 710–713CrossRefGoogle Scholar
Wehr, T.A.Gillin, J.C. & Goodwin, F.K. (1983) Sleep and circadian rhythms in depression. In: New Perspectives in Sleep Research (Chase, M., ed.), Spectrum, New-YorkGoogle Scholar
Wirz-Justice, A.Puhringer, W. & Hole, G. (1979) Response to sleep deprivation: a predictor for therapeutic results with anti-depressant drugs. Am. J. Psychiatry 136, 1222–1223Google Scholar
Wirz-Justice, A.Wolfgang, P. & Gunter, H. (1976) Sleep deprivation and clomipramine in endogenous depression. Lancet 2, 912–914CrossRefGoogle ScholarPubMed
Yamaguchi, N.Maeda, K. & Kuromura, S. (1978) The effects of sleep deprivation on the circulation rhythms of plasma cortisol in depressed patients. Folia Psychiatr. Neurol. Jpn. 342, 479–487Google Scholar
Zander, K.J.Lorenz, A.Wahllander, B.Ackenheil, M. & Ruther, E. (1981) Biogenesis of the antidepressive effect of sleep deprivation. In: Sleep 1980, (Koella, W.P., ed.), Karger, Basel, pp. 9–15Google Scholar
Zimanova, J. & Vojtechovsky, M. (1974) Sleep deprivation as a potentiation of antidepressive pharmacotherapy. Acta Nerv. Super. (Praha) 16, 188–189Google ScholarPubMed
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