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Rapid Eye Movement Sleep Deprivation as a Probe in Elderly Subjects

Rapid Eye Movement Sleep Deprivation as a Probe in Elderly Subjects Abstract • The effects of a 2-night rapid eye movement (REM) sleep deprivation (RSD) procedure on electroencephalographic sleep and mood were examined in 15 healthy elderly control subjects, 14 elderly patients with endogenous depression, and 15 patients with primary degenerative dementia. Compared with control subjects, both patient groups maintained a higher amount of REM sleep time and REM activity during RSD. Unexpectedly, depressed patients showed little rebound in visually scored or automated REM sleep measures following RSD, and they showed stability of REM activity temporal distribution from baseline to recovery conditions. This contrasted with the rebound in REM sleep activity seen in control subjects, and the more modest increase in demented patients. The RSD was fairly specific, with some impact on delta sleep during the procedure but not during recovery sleep. Mood ratings were unaffected by RSD. These findings demonstrated a greater plasticity of REM sleep regulation in the healthy elderly control subjects and suggested a higher REM "pressure" with a "ceiling effect" in depressed patients. Patients with dementia appeared to have an impaired capacity to respond to the challenge of RSD. References 1. Miles LE, Dement WC. Sleep and aging . Sleep . 1980;3:119-220. 2. Feinberg I, Koresko RL, Heller N. EEG sleep patterns as a function of normal and pathological aging in men . J Psychiatr Res . 1967;5:107-144.Crossref 3. Williams RL, Karacan I, Hursch CJ. EEG of Human Sleep: Clinical Applications . New York, NY: John Wiley & Sons Inc; 1974. 4. Reynolds CF, Kupfer DJ, Taska LS, Hoch CC, Sewitch DE, Spiker DG. Sleep of healthy seniors: a revisit . Sleep . 1985;8:20-29. 5. Reynolds CF, Kupfer DJ, Taska LS, Hoch CC, Spiker DG, Sewitch DE, Zimmer B, Marin RS, Nelson JP, Martin D, Morycz R. EEG sleep in elderly depressed, demented, and healthy subjects . Biol Psychiatry . 1985;20:431-442.Crossref 6. Reynolds CF, Kupfer DJ, Houck PR, Hoch CC, Stack JA, Berman SR, Zimmer B. Reliable discrimination of elderly depressed and demented patients by electroencephalographic sleep data . Arch Gen Psychiatry . 1988;45:258-264.Crossref 7. Bliwise D, Tinklenberg J, Davies H, Pursley A, Petta D, Yesavage J, Widrow L, Guilleminault C, Zarcone V, Dement W. Sleep patterns in Alzheimer's disease (AD) . Sleep Res . 1986;15:49. 8. Vitiello MV, Bokan JA, Kukull WA, Muniz RL, Smallwood RG, Prinz PN. Rapid eye movement sleep measures of Alzheimer's-type dementia patients and optimally healthy aged individuals . Biol Psychiatry . 1984;19:721-734. 9. Reynolds CF, Kupfer DJ. Sleep research in affective illness: state of the art circa 1987 . Sleep . 1987;10:199-215. 10. Vogel GW, Vogel F, McAbee RS, Thurmond AJ. Improvement of depression by REM sleep deprivation . Arch Gen Psychiatry . 1980;37:247-253.Crossref 11. Kupfer DJ, Ehlers CL. Two roads to REM latency . Arch Gen Psychiatry . In press. 12. Joffe RT, Brown P. Clinical and biological correlates of sleep deprivation in depression . Can J Psychiatry . 1984;29:530-536. 13. Vogel GW, Thurmond A, Gibbons P, et al. REM sleep reduction effects on depression syndromes . Arch Gen Psychiatry . 1975;32:765-777.Crossref 14. Bonnet MH. Effect of 64 hours of sleep deprivation upon sleep in geriatric normals and insomniacs . Neurobiol Aging . 1986;7:89-96.Crossref 15. Webb WB. Sleep stage responses of older and younger subjects to sleep deprivation . Electroencephalogr Clin Neurophysiol . 1981;52:368-371.Crossref 16. Reynolds CF, Kupfer DJ, Hoch CC, Stack JA, Houck PR, Berman SR. Sleep deprivation in healthy elderly men and women: effects on mood and on sleep during recovery . Sleep . 1986;9:492-501. 17. Reynolds CF, Kupfer DJ, Hoch CC, Stack JA, Houck PR, Berman SR. Sleep deprivation effects in older endogenous depressed patients . Psychiatry Res . 1987;21:95-109.Crossref 18. Reynolds CF, Kupfer DJ, Hoch CC, Houck PR, Stack JA, Berman SR, Campbell PI, Zimmer B. Sleep deprivation as a probe in the elderly . Arch Gen Psychiatry . 1987;44:982-992.Crossref 19. Buysse DJ, Reynolds CF, Kupfer DJ, Houck PR, Hoch CC, Stack JA, Berman SR. EEG sleep in depressive pseudodementia . Arch Gen Psychiatry . 1988;45:568-575.Crossref 20. Spitzer RL, Endicott J, Robins E. Research Diagnostic Criteria: Rationale and reliability . Arch Gen Psychiatry . 1978;35:773-782.Crossref 21. Hamilton M. Development of a ratings scale for primary depressive illness . Br J Soc Clin Psychol . 1967;6:278-279.Crossref 22. Folstein MF, Folstein SE, McHugh PR. `Mini-Mental State': a practical method for grading the cognitive state of patients for the clinician . J Psychiatry Res . 1975;12:189-198.Crossref 23. Blessed G, Tomlinson BE, Roth M. The association between quantitative measures of dementia and of senile change in the cerebral gray matter of elderly subjects . Br J Psychiatry . 1968;144:797-811.Crossref 24. Hughes CP, Berg L, Danzinger WL, Cohen LA, Martin EL. A new clinical scale for the staging of dementia . Br J Psychiatry . 1982;140:566-572.Crossref 25. Rosen WG, Terry RD, Fuld PA, Katzman R, Peck A. Pathological verification of ischemia score in differentiation of dementias . Ann Neurobiol . 1979;7:486-488.Crossref 26. American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders . 3rd ed. Washington, DC: American Psychiatry Association; 1980. 27. Covi L, Lipman RS, Frighi L, Rawling R. Transcultural comparability of outpatient self ratings, II: the Profile of Mood States (POMS) . Drugs Exp Clin Res . 1977;1:141-151. 28. Rechtschaffen A, Kales AA, eds. A Manual of Standardized Terminology, Techniques, and Scoring System for Sleep Stages of Human Subjects . Bethesda, Md: National Institute for Nervous Diseases and Blindness; 968. 29. Kupfer DJ, Ulrich RF, Coble, PA, Jarrett DB, Grochocinski VJ, Doman J, Matthews G, Borbély A. Application of automated REM and slow wave sleep analysis, I: normal and depressed subjects . Psychiatry Res . 1984;13:325-334.Crossref 30. Southmayd SE, Cairns J, Delva NJ, Letemendia FJJ. Awake, perchance asleep? Br J Psychiatry . 1986;148:748-749.Crossref 31. Wiegand M, Lauer C, Berger M, Von Zerssen D, Zulley J. The influence of daytime naps on the therapeutic effect of sleep deprivation . Biol Psychiatry . 1987;22:386-389.Crossref 32. Kales A, Wilson T, Kales JD, Jacobson A, Paulson MJ, Kollar E, Walter RD. Measurement of all-night sleep in normal elderly persons: effects of aging . J Am Geriatr Soc . 1967;15:405-414. 33. Gillin JC, Buchsbaum MS, Jacobs LS, Fram DH, Redford BW, Vaughan TB, Mellon E, Snyder F, Wyatt RJ. Partial REM sleep deprivation, schizophrenia and field articulation . Arch Gen Psychiatry . 1974;30:653-662.Crossref 34. Zarcone V, Azumi K, Dement W, Gulevich G, Kraemer H, Pivik T. REM phase deprivation and schizophrenia, II : Arch Gen Psychiatry . 1975;32:1431-1436.Crossref 35. Zarcone V, Gulevich G, Pivik T, Dement W. Partial REM phase deprivation and schizophrenia . Arch Gen Psychiatry . 1968;18:194-202.Crossref 36. Borbély AA. A two-process model of sleep regulation . Hum Neurobiol . 1982;1:195-204. 37. Borbély AA, Wirz-Justice A. Sleep, sleep deprivation, and depression: a hypothesis derived from a model of sleep regulation . Hum Neurobiol . 1982;1:205-210. 38. Borbély AA. The two-process model of sleep regulation . In: Kupfer DJ, Monk TH, Barchas JD, eds. Biological Rhythms and Mental Disorders . 1988;3:59-81. 39. Kupfer DJ, Ulrich RF, Coble PA, Jarrett DB, Grochocinski VJ, Doman J, Matthews G, Borbély AA. Application of automated REM and slow wave sleep analysis, II: testing the assumptions of the two-process model of sleep regulation in normal and depressed subjects . Psychiatry Res . 1984;13:335-343.Crossref 40. Goetze U, Tolle R. Antidepressive Wirkung des partiellen Schlafentzuges während der 1. Halfte der Nacht . Psychiatria Clin . 1881;14:129-149. 41. Schilgen B, Tolle R. Partial sleep deprivation as therapy for depression . Arch Gen Psychiatry . 1980;37:267-271.Crossref 42. Sack DA, James SP, Rosenthal NE, Wehr TA. Partial sleep deprivation and phase advance therapy for depression . In: Chagass C, Josiassen RC, Bridger WH, Weiss KJ, Stoff D, Simpson GM, eds. Biological Psychiatry '85 . New York, NY: Elsevier Science Publishing Co Inc; 1986:972-974. 43. Van Den Hoofdakker RH, Beersma DGM. On the contribution of sleep wake physiology to the explanation and the treatment of depression . Acta Psychiatrica Scand Suppl . 1988;77:53-71Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of General Psychiatry American Medical Association

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American Medical Association
Copyright
Copyright © 1990 American Medical Association. All Rights Reserved.
ISSN
0003-990X
eISSN
1598-3636
DOI
10.1001/archpsyc.1990.01810240048009
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Abstract

Abstract • The effects of a 2-night rapid eye movement (REM) sleep deprivation (RSD) procedure on electroencephalographic sleep and mood were examined in 15 healthy elderly control subjects, 14 elderly patients with endogenous depression, and 15 patients with primary degenerative dementia. Compared with control subjects, both patient groups maintained a higher amount of REM sleep time and REM activity during RSD. Unexpectedly, depressed patients showed little rebound in visually scored or automated REM sleep measures following RSD, and they showed stability of REM activity temporal distribution from baseline to recovery conditions. This contrasted with the rebound in REM sleep activity seen in control subjects, and the more modest increase in demented patients. The RSD was fairly specific, with some impact on delta sleep during the procedure but not during recovery sleep. Mood ratings were unaffected by RSD. These findings demonstrated a greater plasticity of REM sleep regulation in the healthy elderly control subjects and suggested a higher REM "pressure" with a "ceiling effect" in depressed patients. Patients with dementia appeared to have an impaired capacity to respond to the challenge of RSD. References 1. Miles LE, Dement WC. Sleep and aging . Sleep . 1980;3:119-220. 2. Feinberg I, Koresko RL, Heller N. EEG sleep patterns as a function of normal and pathological aging in men . J Psychiatr Res . 1967;5:107-144.Crossref 3. Williams RL, Karacan I, Hursch CJ. EEG of Human Sleep: Clinical Applications . New York, NY: John Wiley & Sons Inc; 1974. 4. Reynolds CF, Kupfer DJ, Taska LS, Hoch CC, Sewitch DE, Spiker DG. Sleep of healthy seniors: a revisit . Sleep . 1985;8:20-29. 5. Reynolds CF, Kupfer DJ, Taska LS, Hoch CC, Spiker DG, Sewitch DE, Zimmer B, Marin RS, Nelson JP, Martin D, Morycz R. EEG sleep in elderly depressed, demented, and healthy subjects . Biol Psychiatry . 1985;20:431-442.Crossref 6. Reynolds CF, Kupfer DJ, Houck PR, Hoch CC, Stack JA, Berman SR, Zimmer B. Reliable discrimination of elderly depressed and demented patients by electroencephalographic sleep data . Arch Gen Psychiatry . 1988;45:258-264.Crossref 7. Bliwise D, Tinklenberg J, Davies H, Pursley A, Petta D, Yesavage J, Widrow L, Guilleminault C, Zarcone V, Dement W. Sleep patterns in Alzheimer's disease (AD) . Sleep Res . 1986;15:49. 8. Vitiello MV, Bokan JA, Kukull WA, Muniz RL, Smallwood RG, Prinz PN. Rapid eye movement sleep measures of Alzheimer's-type dementia patients and optimally healthy aged individuals . Biol Psychiatry . 1984;19:721-734. 9. Reynolds CF, Kupfer DJ. Sleep research in affective illness: state of the art circa 1987 . Sleep . 1987;10:199-215. 10. Vogel GW, Vogel F, McAbee RS, Thurmond AJ. Improvement of depression by REM sleep deprivation . Arch Gen Psychiatry . 1980;37:247-253.Crossref 11. Kupfer DJ, Ehlers CL. Two roads to REM latency . Arch Gen Psychiatry . In press. 12. Joffe RT, Brown P. Clinical and biological correlates of sleep deprivation in depression . Can J Psychiatry . 1984;29:530-536. 13. Vogel GW, Thurmond A, Gibbons P, et al. REM sleep reduction effects on depression syndromes . Arch Gen Psychiatry . 1975;32:765-777.Crossref 14. Bonnet MH. Effect of 64 hours of sleep deprivation upon sleep in geriatric normals and insomniacs . Neurobiol Aging . 1986;7:89-96.Crossref 15. Webb WB. Sleep stage responses of older and younger subjects to sleep deprivation . Electroencephalogr Clin Neurophysiol . 1981;52:368-371.Crossref 16. Reynolds CF, Kupfer DJ, Hoch CC, Stack JA, Houck PR, Berman SR. Sleep deprivation in healthy elderly men and women: effects on mood and on sleep during recovery . Sleep . 1986;9:492-501. 17. Reynolds CF, Kupfer DJ, Hoch CC, Stack JA, Houck PR, Berman SR. Sleep deprivation effects in older endogenous depressed patients . Psychiatry Res . 1987;21:95-109.Crossref 18. Reynolds CF, Kupfer DJ, Hoch CC, Houck PR, Stack JA, Berman SR, Campbell PI, Zimmer B. Sleep deprivation as a probe in the elderly . Arch Gen Psychiatry . 1987;44:982-992.Crossref 19. Buysse DJ, Reynolds CF, Kupfer DJ, Houck PR, Hoch CC, Stack JA, Berman SR. EEG sleep in depressive pseudodementia . Arch Gen Psychiatry . 1988;45:568-575.Crossref 20. Spitzer RL, Endicott J, Robins E. Research Diagnostic Criteria: Rationale and reliability . Arch Gen Psychiatry . 1978;35:773-782.Crossref 21. Hamilton M. Development of a ratings scale for primary depressive illness . Br J Soc Clin Psychol . 1967;6:278-279.Crossref 22. Folstein MF, Folstein SE, McHugh PR. `Mini-Mental State': a practical method for grading the cognitive state of patients for the clinician . J Psychiatry Res . 1975;12:189-198.Crossref 23. Blessed G, Tomlinson BE, Roth M. The association between quantitative measures of dementia and of senile change in the cerebral gray matter of elderly subjects . Br J Psychiatry . 1968;144:797-811.Crossref 24. Hughes CP, Berg L, Danzinger WL, Cohen LA, Martin EL. A new clinical scale for the staging of dementia . Br J Psychiatry . 1982;140:566-572.Crossref 25. Rosen WG, Terry RD, Fuld PA, Katzman R, Peck A. Pathological verification of ischemia score in differentiation of dementias . Ann Neurobiol . 1979;7:486-488.Crossref 26. American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders . 3rd ed. Washington, DC: American Psychiatry Association; 1980. 27. Covi L, Lipman RS, Frighi L, Rawling R. Transcultural comparability of outpatient self ratings, II: the Profile of Mood States (POMS) . Drugs Exp Clin Res . 1977;1:141-151. 28. Rechtschaffen A, Kales AA, eds. A Manual of Standardized Terminology, Techniques, and Scoring System for Sleep Stages of Human Subjects . Bethesda, Md: National Institute for Nervous Diseases and Blindness; 968. 29. Kupfer DJ, Ulrich RF, Coble, PA, Jarrett DB, Grochocinski VJ, Doman J, Matthews G, Borbély A. Application of automated REM and slow wave sleep analysis, I: normal and depressed subjects . Psychiatry Res . 1984;13:325-334.Crossref 30. Southmayd SE, Cairns J, Delva NJ, Letemendia FJJ. Awake, perchance asleep? Br J Psychiatry . 1986;148:748-749.Crossref 31. Wiegand M, Lauer C, Berger M, Von Zerssen D, Zulley J. The influence of daytime naps on the therapeutic effect of sleep deprivation . Biol Psychiatry . 1987;22:386-389.Crossref 32. Kales A, Wilson T, Kales JD, Jacobson A, Paulson MJ, Kollar E, Walter RD. Measurement of all-night sleep in normal elderly persons: effects of aging . J Am Geriatr Soc . 1967;15:405-414. 33. Gillin JC, Buchsbaum MS, Jacobs LS, Fram DH, Redford BW, Vaughan TB, Mellon E, Snyder F, Wyatt RJ. Partial REM sleep deprivation, schizophrenia and field articulation . Arch Gen Psychiatry . 1974;30:653-662.Crossref 34. Zarcone V, Azumi K, Dement W, Gulevich G, Kraemer H, Pivik T. REM phase deprivation and schizophrenia, II : Arch Gen Psychiatry . 1975;32:1431-1436.Crossref 35. Zarcone V, Gulevich G, Pivik T, Dement W. Partial REM phase deprivation and schizophrenia . Arch Gen Psychiatry . 1968;18:194-202.Crossref 36. Borbély AA. A two-process model of sleep regulation . Hum Neurobiol . 1982;1:195-204. 37. Borbély AA, Wirz-Justice A. Sleep, sleep deprivation, and depression: a hypothesis derived from a model of sleep regulation . Hum Neurobiol . 1982;1:205-210. 38. Borbély AA. The two-process model of sleep regulation . In: Kupfer DJ, Monk TH, Barchas JD, eds. Biological Rhythms and Mental Disorders . 1988;3:59-81. 39. Kupfer DJ, Ulrich RF, Coble PA, Jarrett DB, Grochocinski VJ, Doman J, Matthews G, Borbély AA. Application of automated REM and slow wave sleep analysis, II: testing the assumptions of the two-process model of sleep regulation in normal and depressed subjects . Psychiatry Res . 1984;13:335-343.Crossref 40. Goetze U, Tolle R. Antidepressive Wirkung des partiellen Schlafentzuges während der 1. Halfte der Nacht . Psychiatria Clin . 1881;14:129-149. 41. Schilgen B, Tolle R. Partial sleep deprivation as therapy for depression . Arch Gen Psychiatry . 1980;37:267-271.Crossref 42. Sack DA, James SP, Rosenthal NE, Wehr TA. Partial sleep deprivation and phase advance therapy for depression . In: Chagass C, Josiassen RC, Bridger WH, Weiss KJ, Stoff D, Simpson GM, eds. Biological Psychiatry '85 . New York, NY: Elsevier Science Publishing Co Inc; 1986:972-974. 43. Van Den Hoofdakker RH, Beersma DGM. On the contribution of sleep wake physiology to the explanation and the treatment of depression . Acta Psychiatrica Scand Suppl . 1988;77:53-71Crossref

Journal

Archives of General PsychiatryAmerican Medical Association

Published: Dec 1, 1990

References