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Disease and treatment

Depressed people sleep better when they stay awake

Depressed people need to be treated rapidly and effectively because pharmaceutical treatment does not start to work for 5–7 weeks. New research shows that therapy in which people stay awake for 36 hours and then sleep helps to reduce depression in the short term but improves sleep patterns in the long term.

Suddenly, for no logical reason, psyche and behaviour change. Feelings of helplessness and impotence fill people’s days and nights. Depression is a slow killer that propels its victims to the verge of suicide. Antidepressant drugs are one solution, but because these do not necessarily work for everyone, and certainly not immediately, intensive research is being conducted on alternative ways to treat people with depression.

One of the most promising supplementary treatments is wake therapy, in which people with depression are kept awake for 36 hours before being allowed to sleep. Previous studies have shown that this sleep deprivation is effective in the short term, but the long-term effects are unknown. A research group from Aarhus University Hospital has now followed 64 people with moderate to severe depression for 9 weeks to monitor the effects of the therapy.

“We attempted to supplement the normal pharmaceutical treatment for depression with wake and light therapy. Wake therapy had an immediate effect. During the first week, the average score on the Hamilton Rating Scale for Depression dropped from 23 to 17. After 9 weeks, however, the results scarcely differed from the effects of drug treatment,” explains Mette Kragh, the article’s main author and a PhD student at Aarhus University Hospital.

Greater self-confidence

Nevertheless, the study showed that wake therapy had another unexpected effect: it normalized people’s sleep patterns so that they began to sleep better at night. Equally striking was the fact that people undergoing wake therapy had greater self-confidence.

“We saw that people had greater confidence that they could manage challenges. Perhaps this will enable them to manage future symptoms of depression more easily, which is important, since depression often recurs.”

This can thus be used immediately as short-term and effective therapy in the early stages of treatment. In addition, the researchers think that the treatment may be relevant to specific groups of people, such as those for whom drug treatment is less effective. However, further research is required before wake therapy is used more widely.

“Wake therapy is resource intensive to implement, so offering it to the people who are expected to achieve the best results is therefore important. We plan to focus on the characteristics of these people in the future.”

Wake and light therapy for moderate-to-severe depression – a randomized controlled trial” has been published in Acta Psychiatrica Scandinavia. In 2014, the Novo Nordisk Foundation awarded a grant to Mette Kragh, nursing researcher and PhD student at Aarhus University Hospital, for the project Wake and Light Therapy for Inpatients with Depression – Effectiveness of Treatment, Predictors and Patient Perceptions.

Mette Kragh
Forskningssygeplejerske og PhD-studerende
Vågenterapi er en behandlingsmetode, der kan ophæve eller reducere depressive symptomer inden for timer, og i flere undersøgelser er det påvist, at op mod 60 % af patienterne responderede på vågenterapi. Metoden består i, at patienterne holder sig vågne en nat og den efterfølgende dag, i alt 36 timer, hvilket efterfølges af en nats søvn. Lysterapi, stabilisering af døgnrytmen, gentagne vågenterapier og antidepressiva har vist sig at kunne fastholde den akutte effekt af vågenterapi.