SAD-help arrives with the dawn?

Attacks of anxiety, panic and frenzy, and their related depression: a hypothesis

The hypothesis is that the pathogenesis of attacks of anxiety, panic or frenzy (hyperactive disorders) rests on the abnormal activation of the same brain-controlled survival mechanism, and that the subsequent depression is part of this nosological continuum. The acute activation phase would be the counterpart of two principal types of reaction to threat and imminent attack: run-for-life or fight-for-life, sub-served by brain-controlled metabolic activation to make energy available for either. The phase of depression that follows would represent the recovery phase during which homeostatic controls and metabolism, distorted during the acute attacks, are restored to normal. It is further tentatively postulated that anxiety and panic attacks may mimic run-for-life responses, whereas attacks of frenzy might be homologous to fight-for-life. Both the degree of dys-homeostasis and the completeness of the return to normality through the depression phase would depend on severity, duration and, importantly, spacing of the acute attacks. At the limit, severity, long duration and only short intermissions between hyperactive attacks may be postulated to result in persistence of the depression.

Effect of simulated dawn on quality of sleep--a community-based trial

BACKGROUND

Morning light exposure administered as simulated dawn looks a promising method to treat Seasonal Affective Disorder, but it may moreover help with resetting the inaccurate organisation of body clock functions relative to sleep occurring in winter among people in general. Disturbances in sleep patterns are common and may compromise wellbeing even in the short term. Our hypothesis was that simulated dawn could improve the subjective quality of sleep during winter.

METHODS

A community-based trial with 100 volunteer subjects provided with dawn simulators. Study period lasted for eight weeks, and subjects used the dawn simulators for two weeks at a time, each subject acting as his own control (ABAB-design). Main outcome measure was subjective quality of sleep recorded each morning with Groningen Sleep Quality Scale.

RESULTS

77 subjects completed the trial. Quality of sleep improved while subjects were using dawn simulator-devices (p = 0.001). The treatment became beneficial after six days' use of dawn simulator, but the effect did not last after the use was ceased.

CONCLUSION

Dawn simulation may help to improve the subjective quality of sleep, but the benefits are modest. Further research is needed to verify these findings and to elucidate the mechanism by which dawn simulation acts on the sleep-wake pattern.