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Xu YH, Wu F, Yu S, Guo YN, Zhao RR, Zhang RL. Therapeutic sleep deprivation for major depressive disorder: A randomized controlled trial. J Affect Disord 2024; 361:10-16. [PMID: 38844163 DOI: 10.1016/j.jad.2024.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 04/01/2024] [Accepted: 06/02/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Major depressive disorder (MDD) is treated primarily using antidepressant drugs, but clinical effects may be delayed for weeks to months. This study investigated the efficacy of brief therapeutic sleep deprivation (TSD) for inducing rapid improvements in MDD symptoms. METHODS From November 2020 to February 2023, 54 inpatients with MDD were randomly allocated to TSD and Control groups. The TSD group (23 cases) remained awake for 36 h, while the Control group (31 cases) maintained regular sleep patterns. All participants continued regular drug therapy. Mood was assessed using the 24-item Hamilton Depression Scale (HAMD-24) at baseline and post-intervention in both groups. In the TSD group, the Visual Analogue Scale (VAS) was utilized to evaluate subjective mood during and after the intervention. Cognitive function was assessed at baseline and post-intervention using the Montreal Cognitive Assessment (MoCA). Objective sleep parameters were recorded in the TSD group by polysomnography. The follow-up period spanned one week. RESULTS HAMD-24 scores did not differ between groups at baseline or post-intervention. However, the clinical response rate was 34.8 % higher in the TSD group on day 3 post-intervention compared to the Control group (3.2 %), but not sustained by day 7. Moreover, responders demonstrated a faster improvement in the VAS score during TSD than non-responders (p = 0.047). There were no significant differences in MoCA scores or objective sleep parameters between the groups. LIMITATIONS Small sample size and notable attrition rate. CONCLUSIONS Therapeutic sleep deprivation can rapidly improve MDD symptoms without influencing sleep parameters or cognitive functions. Assessment of longer-term effects and identification of factors predictive of TSD response are warranted.
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Affiliation(s)
- Ya-Hui Xu
- Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University; Henan Collaborative Innovation Center for Prevention and Treatment of Mental Disorders; Brain Institute, Henan Academy of Innovations in Medical Science, Xinxiang, China.
| | - Fang Wu
- Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University; Henan Collaborative Innovation Center for Prevention and Treatment of Mental Disorders; Brain Institute, Henan Academy of Innovations in Medical Science, Xinxiang, China
| | - Shuai Yu
- Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University; Henan Collaborative Innovation Center for Prevention and Treatment of Mental Disorders; Brain Institute, Henan Academy of Innovations in Medical Science, Xinxiang, China
| | - Ya-Nan Guo
- Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University; Henan Collaborative Innovation Center for Prevention and Treatment of Mental Disorders; Brain Institute, Henan Academy of Innovations in Medical Science, Xinxiang, China
| | - Rong-Rong Zhao
- Psychiatry Department, First Affiliated Hospital of Henan University of Science and Technology, Luoyang, China
| | - Rui-Ling Zhang
- Department of Sleep Medicine, Second Affiliated Hospital of Xinxiang Medical University; Henan Collaborative Innovation Center for Prevention and Treatment of Mental Disorders; Brain Institute, Henan Academy of Innovations in Medical Science, Xinxiang, China
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Cabrera Y, Koymans KJ, Poe GR, Kessels HW, Van Someren EJW, Wassing R. Overnight neuronal plasticity and adaptation to emotional distress. Nat Rev Neurosci 2024; 25:253-271. [PMID: 38443627 DOI: 10.1038/s41583-024-00799-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/01/2024] [Indexed: 03/07/2024]
Abstract
Expressions such as 'sleep on it' refer to the resolution of distressing experiences across a night of sound sleep. Sleep is an active state during which the brain reorganizes the synaptic connections that form memories. This Perspective proposes a model of how sleep modifies emotional memory traces. Sleep-dependent reorganization occurs through neurophysiological events in neurochemical contexts that determine the fates of synapses to grow, to survive or to be pruned. We discuss how low levels of acetylcholine during non-rapid eye movement sleep and low levels of noradrenaline during rapid eye movement sleep provide a unique window of opportunity for plasticity in neuronal representations of emotional memories that resolves the associated distress. We integrate sleep-facilitated adaptation over three levels: experience and behaviour, neuronal circuits, and synaptic events. The model generates testable hypotheses for how failed sleep-dependent adaptation to emotional distress is key to mental disorders, notably disorders of anxiety, depression and post-traumatic stress with the common aetiology of insomnia.
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Affiliation(s)
- Yesenia Cabrera
- Department of Integrative Biology and Physiology, Brain Research Institute, University of California Los Angeles, Los Angeles, CA, USA
| | - Karin J Koymans
- Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - Gina R Poe
- Department of Integrative Biology and Physiology, Brain Research Institute, University of California Los Angeles, Los Angeles, CA, USA
| | - Helmut W Kessels
- Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, Netherlands
- Department of Synaptic Plasticity and Behaviour, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Society for Arts and Sciences, Amsterdam, Netherlands
| | - Eus J W Van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, An Institute of the Royal Netherlands Society for Arts and Sciences, Amsterdam, Netherlands
- Department of Integrative Neurophysiology and Psychiatry, VU University, Amsterdam UMC, Amsterdam, Netherlands
- Center for Neurogenomics and Cognitive Research, VU University, Amsterdam UMC, Amsterdam, Netherlands
| | - Rick Wassing
- Sleep and Circadian Research, Woolcock Institute of Medical Research, Macquarie University, Sydney, New South Wales, Australia.
- School of Psychological Sciences, Faculty of Medicine Health and Human Sciences, Macquarie University, Sydney, New South Wales, Australia.
- Sydney Local Health District, Sydney, New South Wales, Australia.
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Dahat P, Toriola S, Satnarine T, Zohara Z, Adelekun A, Seffah KD, Dardari L, Salib K, Taha M, Khan S. Correlation of Various Sleep Patterns on Different Types of Memory Retention: A Systematic Review. Cureus 2023; 15:e42294. [PMID: 37614274 PMCID: PMC10442850 DOI: 10.7759/cureus.42294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 07/22/2023] [Indexed: 08/25/2023] Open
Abstract
Sleep has a substantial impact on memory consolidation, although the link between specific sleep patterns and different forms of memory retention is not well-understood. The purpose of this systematic review is to investigate the correlation between varying sleep habits and memory recall. To identify pertinent research published between 2017 and 2023, a thorough check of electronic databases was carried out. Inclusion criteria encompassed peer-reviewed articles published in English, focusing on human participants, and investigating the relationship between sleep patterns and memory retention. Data extraction and quality assessment were performed on selected studies. This research used different strategies and examined several forms of memory retention, including declarative memory, procedural memory, and emotional memory. Several sleep patterns, including sleep duration, sleep stages, and sleep continuity, were investigated. This comprehensive study demonstrated the relationship between adequate sleep duration and memory consolidation, particularly in regard to declarative memory. Furthermore, deep sleep, characterized by slow-wave sleep (SWS), has been associated with superior procedural memory retention. Sleep continuity, as evaluated by reduced sleep fragmentation or undisturbed sleep, influenced memory consolidation across multiple categories of memory. However, the relationship between rapid eye movement (REM) sleep and memory retention remains inconclusive due to conflicting findings. This systematic review emphasizes the significance of various sleep patterns in memory retention. Memory consolidation corresponds with adequate sleep length, deep sleep (or SWS), and sleep continuity. Future research ought to investigate the connection between REM sleep and memory retention. Understanding the impact of specific sleep patterns on memory processes might help guide therapies and interventions to improve memory consolidation and overall cognitive functioning.
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Affiliation(s)
- Purva Dahat
- Medical School, St. Martinus University, Williemstad, CUW
- Research, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Stacy Toriola
- Pathology, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Travis Satnarine
- Pediatrics, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Zareen Zohara
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfax, USA
| | - Ademiniyi Adelekun
- Family Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Kofi D Seffah
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
- Internal Medicine, Piedmont Athens Regional Medical, Athens, USA
| | - Lana Dardari
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Korlos Salib
- General Practice, El Demerdash Hospital, Cairo, EGY
- General Practice, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Maher Taha
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
| | - Safeera Khan
- Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA
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4
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Brodt S, Inostroza M, Niethard N, Born J. Sleep-A brain-state serving systems memory consolidation. Neuron 2023; 111:1050-1075. [PMID: 37023710 DOI: 10.1016/j.neuron.2023.03.005] [Citation(s) in RCA: 40] [Impact Index Per Article: 40.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 02/23/2023] [Accepted: 03/06/2023] [Indexed: 04/08/2023]
Abstract
Although long-term memory consolidation is supported by sleep, it is unclear how it differs from that during wakefulness. Our review, focusing on recent advances in the field, identifies the repeated replay of neuronal firing patterns as a basic mechanism triggering consolidation during sleep and wakefulness. During sleep, memory replay occurs during slow-wave sleep (SWS) in hippocampal assemblies together with ripples, thalamic spindles, neocortical slow oscillations, and noradrenergic activity. Here, hippocampal replay likely favors the transformation of hippocampus-dependent episodic memory into schema-like neocortical memory. REM sleep following SWS might balance local synaptic rescaling accompanying memory transformation with a sleep-dependent homeostatic process of global synaptic renormalization. Sleep-dependent memory transformation is intensified during early development despite the immaturity of the hippocampus. Overall, beyond its greater efficacy, sleep consolidation differs from wake consolidation mainly in that it is supported, rather than impaired, by spontaneous hippocampal replay activity possibly gating memory formation in neocortex.
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Affiliation(s)
- Svenja Brodt
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany; Max-Planck-Institute for Biological Cybernetics, Tübingen, Germany
| | - Marion Inostroza
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Niels Niethard
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany
| | - Jan Born
- Institute of Medical Psychology and Behavioral Neurobiology, University of Tübingen, Tübingen, Germany; Werner Reichert Center for Integrative Neuroscience, University of Tübingen, Tübingen, Germany.
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5
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Zhang F, Niu L, Zhong R, Li S, Le W. Chronic Sleep Disturbances Alters Sleep Structure and Tau Phosphorylation in AβPP/PS1 AD Mice and Their Wild-Type Littermates. J Alzheimers Dis 2023; 92:1341-1355. [PMID: 37038814 DOI: 10.3233/jad-221048] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023]
Abstract
Background: Emerging evidence indicates that sleep disorders are the common non-cognitive symptoms of Alzheimer’s disease (AD), and they may contribute to the pathogenesis of this disease. Objective: In this study, we aim to investigate the effect of chronic sleep deprivation (CSD) on AD-related pathologies with a focus on tau phosphorylation and the underlying DNA methylation regulation. Methods: AβPPswe/PS1ΔE9 AD mice and their wild-type (WT) littermates were subjected to a two-month CSD followed by electroencephalography and electromyography recording. The mice were examined for learning and memory evaluation, then pathological, biochemical, and epigenetic assessments including western blotting, immunofluorescence, dot blotting, and bisulfite sequencing. Results: The results show that CSD caused sleep disorders shown as sleep pattern change, poor sleep maintenance, and increased sleep fragmentation. CSD increased tau phosphorylation at different sites and increased the level of tau kinases in AD and WT mice. The increased expression of cyclin-dependent kinase 5 (CDK5) may result from decreased DNA methylation of CpG sites in the promoter region of CDK5 gene, which might be associated with the downregulation of DNA methyltransferase 3A and 3B. Conclusion: CSD altered AD-related tau phosphorylation through epigenetic modification of tau kinase gene. The findings in this study may give insights into the mechanisms underlying the effects of sleep disorders on AD pathology and provide new therapeutic targets for the treatment of this disease.
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Affiliation(s)
- Feng Zhang
- Center for Clinical and Translational Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
- Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Long Niu
- Center for Clinical Research on Neurological Diseases, the First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Rujia Zhong
- Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Song Li
- Center for Clinical Research on Neurological Diseases, the First Affiliated Hospital, Dalian Medical University, Dalian, China
| | - Weidong Le
- Center for Clinical and Translational Medicine, Shanghai University of Medicine and Health Sciences, Shanghai, China
- Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
- Center for Clinical Research on Neurological Diseases, the First Affiliated Hospital, Dalian Medical University, Dalian, China
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6
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Xia T, Yao Z, Guo X, Liu J, Chen D, Liu Q, Paller KA, Hu X. Updating memories of unwanted emotions during human sleep. Curr Biol 2023; 33:309-320.e5. [PMID: 36584677 PMCID: PMC9979073 DOI: 10.1016/j.cub.2022.12.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 10/21/2022] [Accepted: 12/02/2022] [Indexed: 12/30/2022]
Abstract
Post-learning sleep contributes to memory consolidation. Yet it remains contentious whether sleep affords opportunities to modify or update emotional memories, particularly when people would prefer to forget those memories. Here, we attempted to update memories during sleep, using spoken positive words paired with cues to recent memories of aversive events. Affective updating using positive words during human non-rapid eye movement (NREM) sleep, compared with using neutral words instead, reduced negative affective judgments in post-sleep tests, suggesting that the recalled events were perceived as less aversive. Electroencephalogram (EEG) analyses showed that positive words modulated theta and spindle/sigma activity; specifically, to the extent that theta power was larger for the positive words than for the memory cues that followed, participants judged the memory cues less negatively. Moreover, to the extent that sigma power was larger for the positive words than for the memory cues that followed, participants forgot more episodic details about aversive events. Notably, when the onset of individual positive words coincided with the up-phase of slow oscillations (a state characterized by increased cortical excitability during NREM sleep), affective updating was more successful. In sum, we altered the affective content of memories via the strategic pairing of positive words and memory cues during sleep, linked with EEG theta power increases and the slow oscillation up-phase. These findings suggest novel possibilities for modifying unwanted memories during sleep, which would not require people to consciously confront memories that they prefer to avoid.
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Affiliation(s)
- Tao Xia
- Department of Psychology, The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Ziqing Yao
- Department of Psychology, The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Xue Guo
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu 610068, China
| | - Jing Liu
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
| | - Danni Chen
- Department of Psychology, The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Qiang Liu
- Institute of Brain and Psychological Sciences, Sichuan Normal University, Chengdu 610068, China; Brain and Cognitive Neuroscience Research Center, Liaoning Normal University, Dalian 116029, China.
| | - Ken A Paller
- Department of Psychology and Cognitive Neuroscience Program, Northwestern University, Evanston, IL 60208, USA
| | - Xiaoqing Hu
- Department of Psychology, The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China; HKU-Shenzhen Institute of Research and Innovation, Shenzhen 518057, China.
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7
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Wang X, Yang Y, Xiao A, Zhang N, Miao M, Wang Z, Han J, Wen M. A comparative study of the effect of a gentle ketogenic diet containing medium-chain or long-chain triglycerides on chronic sleep deprivation-induced cognitive deficiency. Food Funct 2022; 13:2283-2294. [PMID: 35141738 DOI: 10.1039/d1fo04087a] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The ketogenic diet (KD) is well known for its neuroprotective effect, but little is known about its prophylactic efficacy against chronic sleep deprivation (SD) induced cognitive deficiency. An emerging study indicated that ferroptosis plays an important role in neurologic diseases but has been rarely reported in chronic SD. Here, we investigated the prophylactic effects of a medium-chain triglyceride-enriched KD (MKD) and a long-chain triglyceride-enriched KD (LKD) on cognitive deficiency and revealed the underlying mechanism focused on ferroptosis in chronic SD model mice. The results showed that the MKD exhibited stronger effects than the LKD on improving cognitive deficiency via suppressing ferroptosis and improving synaptic plasticity. Further mechanism results indicated that MKD produced higher Sirt3 protein levels than LKD, which probably contributed to the synergistic effect of beta hydroxybutyric acid and decanoic acid. Our finds provide novel evidence for the KD as a safe and feasible dietary intervention to prevent chronic SD-induced cognitive deficiency, and suggest a better choice of medium-chain fatty acid-enriched KD.
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Affiliation(s)
- Xueyan Wang
- Institute of Biopharmaceutical Research, Liaocheng University, Liaocheng 252059, China.
| | - Yueqi Yang
- Institute of Biopharmaceutical Research, Liaocheng University, Liaocheng 252059, China.
| | - Aiai Xiao
- Institute of Biopharmaceutical Research, Liaocheng University, Liaocheng 252059, China.
| | - Ning Zhang
- Institute of Biopharmaceutical Research, Liaocheng University, Liaocheng 252059, China.
| | - Mingyong Miao
- Institute of Biopharmaceutical Research, Liaocheng University, Liaocheng 252059, China. .,Department of Biochemistry and Molecular Biology, The College of Basic Medical Sciences, The Second Military Medical University, Shanghai 200433, China
| | - Zhengping Wang
- Institute of Biopharmaceutical Research, Liaocheng University, Liaocheng 252059, China. .,Liaocheng High-Tech Biotechnology Co. Ltd, Liaocheng, 252059, China
| | - Jun Han
- Institute of Biopharmaceutical Research, Liaocheng University, Liaocheng 252059, China. .,Liaocheng High-Tech Biotechnology Co. Ltd, Liaocheng, 252059, China
| | - Min Wen
- Institute of Biopharmaceutical Research, Liaocheng University, Liaocheng 252059, China.
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