TY - JOUR

T1 - A 6-day combined wake and light therapy trial for unipolar depression

AU - Danilenko, Konstantin V.

AU - Lebedinskaia, Maria Y.

AU - Gadetskaia, Evgenia V.

AU - Markov, Alexei A.

AU - Ivanova, Yana A.

AU - Aftanas, Lyubomir I.

N1 - Publisher Copyright: © 2019 Elsevier B.V.

PY - 2019/12/1

Y1 - 2019/12/1

N2 - Background: There are a dozen studies on double or triple chronotherapy in depression (sleep deprivation [wake therapy] + light therapy + sleep advance/stabilization). We investigated efficacy and feasibility of a modified triple chronotherapy protocol. Methods: Thirty-five hospitalized patients with moderately severe non-seasonal depressive disorder, mostly free from antidepressants, underwent a 6-day protocol consisting of partial sleep deprivation late in the second half of the night (from 4:00 to 8:00) in a light therapy room (blue-enhanced white light increased hourly from 600→1300→2200→2800 lx) alternating with recovery nights with morning light treatment from 7:00 to 8:00. Patients were randomized to wear glasses with no filter (clear, N = 19) or filtering blue wavelength (orange-appearance, light intensity diminution by ∼70%, N = 16) during the treatments. Sleep was targeted to be shifted at least 1 h earlier. Depression was scored using HDRS-17 (Hamilton Depression Rating Scale) and BDI-II (Beck Depression Inventory-II) – before and after the 6-days treatment, HDRS-6-SR – daily, and visual analogue scales (VAS) for mood and energy – several times every day. Results: Depression levels significantly declined following the first night and after 6-days treatment, with no difference between white and orange lights. Nevertheless, some superiority of white light emerged with respect to response rate (mood VAS), immediate effect during the 4-h treatment sessions (energy VAS), and expected treatment outcomes. All patients successfully advanced bedtime/wake-up (by 30–40 minutes) and resisted naps during daytime. Limitations: Relatively small sample size. Conclusions: The modified triple chronotherapy was well tolerated and improved depression. Light spectrum/intensity plays some role in the response.

AB - Background: There are a dozen studies on double or triple chronotherapy in depression (sleep deprivation [wake therapy] + light therapy + sleep advance/stabilization). We investigated efficacy and feasibility of a modified triple chronotherapy protocol. Methods: Thirty-five hospitalized patients with moderately severe non-seasonal depressive disorder, mostly free from antidepressants, underwent a 6-day protocol consisting of partial sleep deprivation late in the second half of the night (from 4:00 to 8:00) in a light therapy room (blue-enhanced white light increased hourly from 600→1300→2200→2800 lx) alternating with recovery nights with morning light treatment from 7:00 to 8:00. Patients were randomized to wear glasses with no filter (clear, N = 19) or filtering blue wavelength (orange-appearance, light intensity diminution by ∼70%, N = 16) during the treatments. Sleep was targeted to be shifted at least 1 h earlier. Depression was scored using HDRS-17 (Hamilton Depression Rating Scale) and BDI-II (Beck Depression Inventory-II) – before and after the 6-days treatment, HDRS-6-SR – daily, and visual analogue scales (VAS) for mood and energy – several times every day. Results: Depression levels significantly declined following the first night and after 6-days treatment, with no difference between white and orange lights. Nevertheless, some superiority of white light emerged with respect to response rate (mood VAS), immediate effect during the 4-h treatment sessions (energy VAS), and expected treatment outcomes. All patients successfully advanced bedtime/wake-up (by 30–40 minutes) and resisted naps during daytime. Limitations: Relatively small sample size. Conclusions: The modified triple chronotherapy was well tolerated and improved depression. Light spectrum/intensity plays some role in the response.

KW - Blue-enhanced light

KW - Chronotherapy

KW - Partial sleep deprivation

KW - Unipolar depression

KW - METAANALYSIS

KW - SLEEP-DEPRIVATION

KW - BRIGHT

UR - http://www.scopus.com/inward/record.url?scp=85071322098&partnerID=8YFLogxK

U2 - 10.1016/j.jad.2019.08.051

DO - 10.1016/j.jad.2019.08.051

M3 - Article

C2 - 31472393

AN - SCOPUS:85071322098

VL - 259

SP - 355

EP - 361

JO - Journal of Affective Disorders

JF - Journal of Affective Disorders

SN - 0165-0327

ER -