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48-Hour Sleep-Wake Cycles in Manic-Depressive Illness: Naturalistic Observations and Sleep Deprivation Experiments

48-Hour Sleep-Wake Cycles in Manic-Depressive Illness: Naturalistic Observations and Sleep... Abstract • Wrist motor activity and sleep were monitored longitudinally in 15 rapidly cycling and 52 nonrapidly cycling manicdepressive patients. The majority of patients experienced one or more consecutive 48-hour sleep-wake cycles (alternate nights with no sleep) when they switched out of depression into mania or hypomania. During a depressive phase, nine rapidly cycling patients were asked to simulate a 48-hour sleep-wake cycle by remaining awake for 40 hours (one night's total sleep deprivation). Eight switched out of depression, and seven were rated as manic or hypomanic; indicating that sleep loss (such as occurs with spontaneous 48-hour sleep-wake cycles) may help to trigger switches from depression to mania. The 48-hour sleepwake cycles in patients may depend on a mechanism that is normally present in all humans, since normal persons also spontaneously experience near-48-hour sleep-wake cycles in certain experimental conditions. References 1. Moore RY: Central neural control of circadian rhythms , in Ganong WF, Martini L (eds): Frontiers in Neuroendocrinology . New York, Raven Press, 1978, vol 5, pp 185-206. 2. Lydic R, Schoene WC, Czeisler CA, et al: Structure homologous to the suprachiasmatic nucleus in human brain . Sleep 1980;2:355-362. 3. Wever RA: The Circadian System of Man: Results of Experiments Under Temporal Isolation . New York, Springer-Verlag, 1979. 4. Pittendrigh CS, Daan S: A functional analysis of circadian pacemakers in nocturnal rodents . J Comp Physiol 1976;106:223-355.Crossref 5. Feighner JP, Robins E, Guze SB, et al: Diagnostic criteria for use in psychiatric research . Arch Gen Psychiatry 1972;26:57-63.Crossref 6. Spitzer RL, Endicott J, Robins E: Research Diagnostic Criteria: Rationale and reliability . Arch Gen Psychiatry 1978;35:773-782.Crossref 7. Bunney WE Jr, Hamburg DA: Methods for reliable longitudinal observation of behavior . Arch Gen Psychiatry 1963;9:280-294.Crossref 8. Wehr TA, Goodwin FK: Rapid cycling in manic-depressives induced by tricyclic antidepressants . Arch Gen Psychiatry 1979;36:555-559.Crossref 9. Colburn TR, Smith BM, Guarini JJ, et al: An ambulatory activity monitor with solid-state memory . ISA Trans 1976;15:149-154. 10. Weiss BL, Kupfer DJ, Foster FG, et al: Psychomotor activity, sleep, and biogenic amine metabolites in depression . Biol Psychiatry 1974;9:45-54. 11. Mullaney DJ, Kripke DF, Messin S: Wrist actigraphic estimate of sleep time . Sleep 1980;3:83-92. 12. Kripke DF, Webster JB, Mullaney DJ, et al: Measuring sleep by wrist actigraph: Final report. US Army Tech Rep, to be published. 13. Kupfer DJ, Wyatt R, Snyder S: Comparison between electroencephalographic and systematic nursing observations of sleep in psychiatric patients . J Nerv Ment Dis 1970;151:361-368.Crossref 14. Gjessing RR: Motor activity , in Jenner FA, Gjessing LR (eds): Contribution to the Somatology of Periodic Catatonía . New York, Pergamon Press, 1976, pp 129-138. 15. Gillin JC, Mazure C, Post RM, et al: An EEG sleep study of a bipolar (manic-depressive) patient with a nocturnal switch process . Biol Psychiatry 1977;6:711-718. 16. Stoddard FJ, Post RM, Bunney WE: Slow and rapid psychobiological alterations in a manic depressive patient: Clinical phenomenology . Br J Psychiatry 1977;130:72-78.Crossref 17. Doust JWL, Christie H: Repeated sleep deprivation as a therapeutic Zeitgeber for circular type manic depressive disturbance . Chronobiologia 1980;7:505-511. 18. Svendsen K: Sleep deprivation-therapy in depression . Acta Psychiatr Scand 1976;54:184-192.Crossref 19. Cole MG, Muller HF: Sleep deprivation in the treatment of elderly depressed patients . J Am Geriatr Soc 1976;24:308-313. 20. van Scheyen JD: Slaapdeprivatie bij de behandeling van unipolaire (endogene) vitale depressies . Ned Tijdschr Geneeskd 1977;121:564-568. 21. Post RM, Kopin J, Goodwin FK: Effects of sleep deprivation on mood and central amine metabolism in depressed patients . Arch Gen Psychiatry 1976;33:627-632.Crossref 22. Pflug B: The effect of sleep deprivation on depressed patients . Acta Psychiatr Scand 1976;53:148-158.Crossref 23. Kretschmar JH, Peters UH: Schlafentzug zur Behandlung der endogenen Depression , in Jovanovic UJ (ed): The Nature of Sleep . Stuttgart, West Germany, Gustav Fischer Verlag, 1973. 24. Bhanji S, Roy GA: The treatment of psychotic depression by sleep deprivation: A replication study . Br J Psychiatry 1975;127:222-226.Crossref 25. Perez FD, Sala Ayma JM: La privación de sueno en el tratamiento de la depresión y aminas urinarias . Actas Luso Esp Neurol Psiquiatr 1980;8:461-466. 26. Zimanova J, Vojtechovsky M: Sleep deprivation as a potentiation of antidepressive pharmacolotherapy? Act Nerv Super 1974;16:188-189. 27. Pflug B, Tolle R: Therapie endogener Depressionen durch Schlafentzug. Praktische und Theoretische Konsequenzen . Nervenarzt 1971;42:117-124. 28. Schiigen B, Tolle R: Partial sleep deprivation as therapy for depression . Arch Gen Psychiatry 1980;37:261-271. 29. Chouvet G, Mouret J, Coindet J, et al: Périodicité bicircadienne du cycle veille-sommeil dans des conditions hors du temps . Electroencephalogr Clin Neurophysiol 1974;3:367-380.Crossref 30. Jouvet M, Mouret J, Chouvet G, et al: Toward a 48-hour day: Experimental bicircadian rhythm in man , in Schmitt FS, Worden FG (eds): The Neurosciences: Third Study Program . Cambridge, Mass, MIT Press, 1974, pp 491-497. 31. Siffre M: Six months alone in a cave . Nati Geographic 1975;147:426-435. 32. Czeisler CA: Human Circadian Physiology: Internal Organization of Temperature, Sleep-Wake and Neuroendocrine Rhythms Monitored in an Environment Free of Time Cues, thesis. Stanford (Calif) University, 1978. 33. Lund R: Personality factors and desynchronization of circadian rhythms . Psychosom Med 1974;36:224-228.Crossref 34. Richter CP: Evidence for existence of a yearly clock in surgically and self-blinded chipmunks . Proc Nati Acad Sei USA 1978;75:3517-3521.Crossref 35. Stroebel CF: Biologic rhythm correlates of disturbed behavior in the Rhesus monkey , in Rohles FH (ed): Circadian Rhythms in Nonhuman Primates . New York, S Karger AG, 1969. 36. Wehr TA, Wirz-Justice A, Goodwin FK, et al: Clorgyline slows circadian rhythms , in Radouco-Thomas C, Garcin F (eds): Abstracts of the 12th CINP Congress, Supplement Progress in Neuropsychopharmacology . New York, Pergamon Press, 1980, p 353. 37. Wirz-Justice A, Groos G, Wehr TA: The neuropharmacology of circadian timekeeping, in Aschoff J, Daan S, Groos G (eds): Vertebrate Circadian Systems: Structure and Physiology. New York, Springer Publishing Co Inc, to be published. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

48-Hour Sleep-Wake Cycles in Manic-Depressive Illness: Naturalistic Observations and Sleep Deprivation Experiments

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References (39)

Publisher
American Medical Association
Copyright
Copyright © 1982 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1982.04290050037008
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Abstract

Abstract • Wrist motor activity and sleep were monitored longitudinally in 15 rapidly cycling and 52 nonrapidly cycling manicdepressive patients. The majority of patients experienced one or more consecutive 48-hour sleep-wake cycles (alternate nights with no sleep) when they switched out of depression into mania or hypomania. During a depressive phase, nine rapidly cycling patients were asked to simulate a 48-hour sleep-wake cycle by remaining awake for 40 hours (one night's total sleep deprivation). Eight switched out of depression, and seven were rated as manic or hypomanic; indicating that sleep loss (such as occurs with spontaneous 48-hour sleep-wake cycles) may help to trigger switches from depression to mania. The 48-hour sleepwake cycles in patients may depend on a mechanism that is normally present in all humans, since normal persons also spontaneously experience near-48-hour sleep-wake cycles in certain experimental conditions. References 1. Moore RY: Central neural control of circadian rhythms , in Ganong WF, Martini L (eds): Frontiers in Neuroendocrinology . New York, Raven Press, 1978, vol 5, pp 185-206. 2. Lydic R, Schoene WC, Czeisler CA, et al: Structure homologous to the suprachiasmatic nucleus in human brain . Sleep 1980;2:355-362. 3. Wever RA: The Circadian System of Man: Results of Experiments Under Temporal Isolation . New York, Springer-Verlag, 1979. 4. Pittendrigh CS, Daan S: A functional analysis of circadian pacemakers in nocturnal rodents . J Comp Physiol 1976;106:223-355.Crossref 5. Feighner JP, Robins E, Guze SB, et al: Diagnostic criteria for use in psychiatric research . Arch Gen Psychiatry 1972;26:57-63.Crossref 6. Spitzer RL, Endicott J, Robins E: Research Diagnostic Criteria: Rationale and reliability . Arch Gen Psychiatry 1978;35:773-782.Crossref 7. Bunney WE Jr, Hamburg DA: Methods for reliable longitudinal observation of behavior . Arch Gen Psychiatry 1963;9:280-294.Crossref 8. Wehr TA, Goodwin FK: Rapid cycling in manic-depressives induced by tricyclic antidepressants . Arch Gen Psychiatry 1979;36:555-559.Crossref 9. Colburn TR, Smith BM, Guarini JJ, et al: An ambulatory activity monitor with solid-state memory . ISA Trans 1976;15:149-154. 10. Weiss BL, Kupfer DJ, Foster FG, et al: Psychomotor activity, sleep, and biogenic amine metabolites in depression . Biol Psychiatry 1974;9:45-54. 11. Mullaney DJ, Kripke DF, Messin S: Wrist actigraphic estimate of sleep time . Sleep 1980;3:83-92. 12. Kripke DF, Webster JB, Mullaney DJ, et al: Measuring sleep by wrist actigraph: Final report. US Army Tech Rep, to be published. 13. Kupfer DJ, Wyatt R, Snyder S: Comparison between electroencephalographic and systematic nursing observations of sleep in psychiatric patients . J Nerv Ment Dis 1970;151:361-368.Crossref 14. Gjessing RR: Motor activity , in Jenner FA, Gjessing LR (eds): Contribution to the Somatology of Periodic Catatonía . New York, Pergamon Press, 1976, pp 129-138. 15. Gillin JC, Mazure C, Post RM, et al: An EEG sleep study of a bipolar (manic-depressive) patient with a nocturnal switch process . Biol Psychiatry 1977;6:711-718. 16. Stoddard FJ, Post RM, Bunney WE: Slow and rapid psychobiological alterations in a manic depressive patient: Clinical phenomenology . Br J Psychiatry 1977;130:72-78.Crossref 17. Doust JWL, Christie H: Repeated sleep deprivation as a therapeutic Zeitgeber for circular type manic depressive disturbance . Chronobiologia 1980;7:505-511. 18. Svendsen K: Sleep deprivation-therapy in depression . Acta Psychiatr Scand 1976;54:184-192.Crossref 19. Cole MG, Muller HF: Sleep deprivation in the treatment of elderly depressed patients . J Am Geriatr Soc 1976;24:308-313. 20. van Scheyen JD: Slaapdeprivatie bij de behandeling van unipolaire (endogene) vitale depressies . Ned Tijdschr Geneeskd 1977;121:564-568. 21. Post RM, Kopin J, Goodwin FK: Effects of sleep deprivation on mood and central amine metabolism in depressed patients . Arch Gen Psychiatry 1976;33:627-632.Crossref 22. Pflug B: The effect of sleep deprivation on depressed patients . Acta Psychiatr Scand 1976;53:148-158.Crossref 23. Kretschmar JH, Peters UH: Schlafentzug zur Behandlung der endogenen Depression , in Jovanovic UJ (ed): The Nature of Sleep . Stuttgart, West Germany, Gustav Fischer Verlag, 1973. 24. Bhanji S, Roy GA: The treatment of psychotic depression by sleep deprivation: A replication study . Br J Psychiatry 1975;127:222-226.Crossref 25. Perez FD, Sala Ayma JM: La privación de sueno en el tratamiento de la depresión y aminas urinarias . Actas Luso Esp Neurol Psiquiatr 1980;8:461-466. 26. Zimanova J, Vojtechovsky M: Sleep deprivation as a potentiation of antidepressive pharmacolotherapy? Act Nerv Super 1974;16:188-189. 27. Pflug B, Tolle R: Therapie endogener Depressionen durch Schlafentzug. Praktische und Theoretische Konsequenzen . Nervenarzt 1971;42:117-124. 28. Schiigen B, Tolle R: Partial sleep deprivation as therapy for depression . Arch Gen Psychiatry 1980;37:261-271. 29. Chouvet G, Mouret J, Coindet J, et al: Périodicité bicircadienne du cycle veille-sommeil dans des conditions hors du temps . Electroencephalogr Clin Neurophysiol 1974;3:367-380.Crossref 30. Jouvet M, Mouret J, Chouvet G, et al: Toward a 48-hour day: Experimental bicircadian rhythm in man , in Schmitt FS, Worden FG (eds): The Neurosciences: Third Study Program . Cambridge, Mass, MIT Press, 1974, pp 491-497. 31. Siffre M: Six months alone in a cave . Nati Geographic 1975;147:426-435. 32. Czeisler CA: Human Circadian Physiology: Internal Organization of Temperature, Sleep-Wake and Neuroendocrine Rhythms Monitored in an Environment Free of Time Cues, thesis. Stanford (Calif) University, 1978. 33. Lund R: Personality factors and desynchronization of circadian rhythms . Psychosom Med 1974;36:224-228.Crossref 34. Richter CP: Evidence for existence of a yearly clock in surgically and self-blinded chipmunks . Proc Nati Acad Sei USA 1978;75:3517-3521.Crossref 35. Stroebel CF: Biologic rhythm correlates of disturbed behavior in the Rhesus monkey , in Rohles FH (ed): Circadian Rhythms in Nonhuman Primates . New York, S Karger AG, 1969. 36. Wehr TA, Wirz-Justice A, Goodwin FK, et al: Clorgyline slows circadian rhythms , in Radouco-Thomas C, Garcin F (eds): Abstracts of the 12th CINP Congress, Supplement Progress in Neuropsychopharmacology . New York, Pergamon Press, 1980, p 353. 37. Wirz-Justice A, Groos G, Wehr TA: The neuropharmacology of circadian timekeeping, in Aschoff J, Daan S, Groos G (eds): Vertebrate Circadian Systems: Structure and Physiology. New York, Springer Publishing Co Inc, to be published.

Journal

Archives of General Psychiatry – American Medical Association

Published: May 1, 1982

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