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Less time in bed did not improve antidepressant response
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Restricting time in bed to 6 hours for 2 weeks did not improve antidepressant treatment response among individuals with major depressive disorder, according to recent findings.
“It’s important to find practical and safe strategies that can enhance our traditional depression therapies, so we decided to evaluate a more modest amount of sleep deprivation that could easily be implemented alongside medication treatment,” J. Todd Arnedt, PhD, of University of Michigan, Ann Arbor, said in a press release. “Although we predicted the group with restricted time in bed would have a better response, based on previous sleep deprivation research in depression, we actually found the opposite.”
To assess effects of restricted time in bed on antidepressant treatment response, researchers conducted a randomized clinical trial among 68 adults with DSM-IV major depressive disorder (MDD). Study participants received 8 weeks of open-label fluoxetine, ranging from 20 mg to 40 mg, and were assigned to 8-hour time in bed (n = 19), 6-hour time in bed with a 2-hour bedtime delay (n = 24) or 6-hour time in bed with a 2-hour rise time advance (n = 25) for the first 2 weeks.
Mixed effects models indicated less severe depression among individuals in the 8-hour time in bed group, compared with the 6-hour time in bed group overall (P < .05).
By week 8, remission occurred in 63.2% of the 8-hour group and 32.6% of the 6-hour group (P < .05).
Remission onset occurred earlier among individuals with 8 hours in bed (HR = 0.43; 95% CI, 0.2-0.91; P < .03), with no differences between those who received either 6-hour time in bed condition.
“We found that a nightly 6-hour [time in bed] schedule during the initial 2 weeks of antidepressant therapy did not accelerate or augment treatment response in young adults with depression; instead, our findings raise the possibility that adequate [time in bed] duration may positively impact treatment response,” Arnedt and colleagues wrote. “Future studies that optimize or extend sleep duration while initiating antidepressant therapy are needed to address this question directly. In addition, more work is needed with larger, more ethnically diverse, and older samples. Future treatment studies should systematically include measures to identify potentially important clinical moderators (eg, diurnal mood variation) and sleep-related moderators (eg, circadian preference, insomnia) of antidepressant treatment response in addition to evaluation of potential mechanisms of adjunctive depression treatments.” – by Amanda Oldt
Disclosure: Arendt reports no relevant financial disclosures. Please see the full study for a list of all authors’ relevant financial disclosures.