Critically-timed sleep+light interventions differentially improve mood in pregnancy vs. postpartum depression by shifting melatonin rhythms
Testing the hypothesis that combined wake + light therapy improves mood in pregnant vs. postpartum depressed participants (DP) by differentially altering melatonin and sleep timing. Initially 89 women, 37 pregnant (21 normal controls-NC; 16 DP) and 52 postpartum (27 NCs; 25 DP), were randomized to a...
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| Veröffentlicht in: | Journal of affective disorders 2023-03, Vol.324, p.250-258 |
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| container_title | Journal of affective disorders |
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| creator | Parry, Barbara L. Meliska, Charles J. Sorenson, Diane L. Martinez, L. Fernando Lopez, Ana M. Dawes, Sharron E. Elliott, Jeffrey A. Hauger, Richard L. |
| description | Testing the hypothesis that combined wake + light therapy improves mood in pregnant vs. postpartum depressed participants (DP) by differentially altering melatonin and sleep timing.
Initially 89 women, 37 pregnant (21 normal controls-NC; 16 DP) and 52 postpartum (27 NCs; 25 DP), were randomized to a parallel trial of a phase-delay intervention (PDI): 1-night of early-night wake therapy (sleep 3-7 am) + 6-weeks of evening bright white light (Litebook Advantage) for 60 min starting 90 min before bedtime, vs. a Phase-advance intervention (PAI): 1-night of late-night wake therapy (sleep 9 pm-1 am) + 6-weeks of morning bright white light for 60 min within 30 min of wake time. Blinded clinicians assessed mood weekly by structured interview, and participants completed subjective ratings, a Morningness-Eveningness questionnaire, actigraphy, and collected 2 overnight urine samples for 6-sulphatoxy melatonin (6-SMT).
In pregnant DP, mood improved more after the PDI vs. PAI (p = .016), whereas in postpartum DP, mood improved more after the PAI vs. PDI (p = .019). After wake therapy, 2 weeks of light treatment was as efficacious as 6 weeks (p > .05). In postpartum DP, PAI phase-advanced 6-SMT offset and acrophase (p |
| doi_str_mv | 10.1016/j.jad.2022.12.079 |
| format | Article |
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Initially 89 women, 37 pregnant (21 normal controls-NC; 16 DP) and 52 postpartum (27 NCs; 25 DP), were randomized to a parallel trial of a phase-delay intervention (PDI): 1-night of early-night wake therapy (sleep 3-7 am) + 6-weeks of evening bright white light (Litebook Advantage) for 60 min starting 90 min before bedtime, vs. a Phase-advance intervention (PAI): 1-night of late-night wake therapy (sleep 9 pm-1 am) + 6-weeks of morning bright white light for 60 min within 30 min of wake time. Blinded clinicians assessed mood weekly by structured interview, and participants completed subjective ratings, a Morningness-Eveningness questionnaire, actigraphy, and collected 2 overnight urine samples for 6-sulphatoxy melatonin (6-SMT).
In pregnant DP, mood improved more after the PDI vs. PAI (p = .016), whereas in postpartum DP, mood improved more after the PAI vs. PDI (p = .019). After wake therapy, 2 weeks of light treatment was as efficacious as 6 weeks (p > .05). In postpartum DP, PAI phase-advanced 6-SMT offset and acrophase (p < .05), which correlated positively with mood improvement magnitude (p = .003).
Small N.
Mood improved more after 2 weeks of the PDI in pregnant DP, but more after 2 weeks of PAI in postpartum DP in which improvement magnitude correlated with 6-SMT phase-advance. Thus, critically-timed Sleep + Light Interventions provide safe, efficacious, rapid-acting, well-tolerated, at-home, non-pharmaceutical treatments for peripartum DP.
•Melatonin rhythms are phase-advanced in pregnancy depression; phase-delayed in postpartum depression•Sleep+light interventions that phase-delay rhythms improve mood in pregnancy depression•Sleep+light interventions that phase-advance rhythms improve mood in postpartum depression•Sleep+light interventions benefit mood within 2 weeks•Sleep+light interventions can be administered at home</description><identifier>ISSN: 0165-0327</identifier><identifier>EISSN: 1573-2517</identifier><identifier>DOI: 10.1016/j.jad.2022.12.079</identifier><identifier>PMID: 36586616</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Affect ; Chronotherapy ; Circadian Rhythm ; Depression, Postpartum - therapy ; Female ; Humans ; Light treatment ; Melatonin ; Melatonin - therapeutic use ; Peripartum depression ; Pregnancy ; Sleep ; Wake therapy</subject><ispartof>Journal of affective disorders, 2023-03, Vol.324, p.250-258</ispartof><rights>2023 Elsevier B.V.</rights><rights>Copyright © 2023 Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3119-39bdf4a4fb4c8f977e9f13ea18dacef142ccca36d42ee62b74e08a966ed489383</citedby><cites>FETCH-LOGICAL-c3119-39bdf4a4fb4c8f977e9f13ea18dacef142ccca36d42ee62b74e08a966ed489383</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0165032722014392$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/36586616$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Parry, Barbara L.</creatorcontrib><creatorcontrib>Meliska, Charles J.</creatorcontrib><creatorcontrib>Sorenson, Diane L.</creatorcontrib><creatorcontrib>Martinez, L. Fernando</creatorcontrib><creatorcontrib>Lopez, Ana M.</creatorcontrib><creatorcontrib>Dawes, Sharron E.</creatorcontrib><creatorcontrib>Elliott, Jeffrey A.</creatorcontrib><creatorcontrib>Hauger, Richard L.</creatorcontrib><title>Critically-timed sleep+light interventions differentially improve mood in pregnancy vs. postpartum depression by shifting melatonin rhythms</title><title>Journal of affective disorders</title><addtitle>J Affect Disord</addtitle><description>Testing the hypothesis that combined wake + light therapy improves mood in pregnant vs. postpartum depressed participants (DP) by differentially altering melatonin and sleep timing.
Initially 89 women, 37 pregnant (21 normal controls-NC; 16 DP) and 52 postpartum (27 NCs; 25 DP), were randomized to a parallel trial of a phase-delay intervention (PDI): 1-night of early-night wake therapy (sleep 3-7 am) + 6-weeks of evening bright white light (Litebook Advantage) for 60 min starting 90 min before bedtime, vs. a Phase-advance intervention (PAI): 1-night of late-night wake therapy (sleep 9 pm-1 am) + 6-weeks of morning bright white light for 60 min within 30 min of wake time. Blinded clinicians assessed mood weekly by structured interview, and participants completed subjective ratings, a Morningness-Eveningness questionnaire, actigraphy, and collected 2 overnight urine samples for 6-sulphatoxy melatonin (6-SMT).
In pregnant DP, mood improved more after the PDI vs. PAI (p = .016), whereas in postpartum DP, mood improved more after the PAI vs. PDI (p = .019). After wake therapy, 2 weeks of light treatment was as efficacious as 6 weeks (p > .05). In postpartum DP, PAI phase-advanced 6-SMT offset and acrophase (p < .05), which correlated positively with mood improvement magnitude (p = .003).
Small N.
Mood improved more after 2 weeks of the PDI in pregnant DP, but more after 2 weeks of PAI in postpartum DP in which improvement magnitude correlated with 6-SMT phase-advance. Thus, critically-timed Sleep + Light Interventions provide safe, efficacious, rapid-acting, well-tolerated, at-home, non-pharmaceutical treatments for peripartum DP.
•Melatonin rhythms are phase-advanced in pregnancy depression; phase-delayed in postpartum depression•Sleep+light interventions that phase-delay rhythms improve mood in pregnancy depression•Sleep+light interventions that phase-advance rhythms improve mood in postpartum depression•Sleep+light interventions benefit mood within 2 weeks•Sleep+light interventions can be administered at home</description><subject>Affect</subject><subject>Chronotherapy</subject><subject>Circadian Rhythm</subject><subject>Depression, Postpartum - therapy</subject><subject>Female</subject><subject>Humans</subject><subject>Light treatment</subject><subject>Melatonin</subject><subject>Melatonin - therapeutic use</subject><subject>Peripartum depression</subject><subject>Pregnancy</subject><subject>Sleep</subject><subject>Wake therapy</subject><issn>0165-0327</issn><issn>1573-2517</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc2qFDEQhYMo3vHqA7iRLAXpNj_dSQdXMvgHF9zoOqSTykyG7nSbZAb6GXxpM8zVpauiqO8cquog9JqSlhIq3p_ak3EtI4y1lLVEqidoR3vJG9ZT-RTtKtM3hDN5h17kfCKECCXJc3THRT8IQcUO_d6nUII107Q1JczgcJ4A1ndTOBwLDrFAukAsYYkZu-A9pGt3xXGY17RcAM_L4iqJ1wSHaKLd8CW3eF1yWU0q5xk7qKOcqwceN5yPwZcQD3iGyZQlVmU6buU455fomTdThleP9R79_Pzpx_5r8_D9y7f9x4fGckpVw9XofGc6P3Z28EpKUJ5yMHRwxoKnHbPWGi5cxwAEG2UHZDBKCHDdoPjA79Hbm2_d_9cZctFzyBamyURYzlkz2SslqBxkRekNtWnJOYHXawqzSZumRF8z0CddM9DXDDRlumZQNW8e7c9jfeg_xd-nV-DDDYB65CVA0tkGiBZcSGCLdkv4j_0ffaOcUg</recordid><startdate>20230301</startdate><enddate>20230301</enddate><creator>Parry, Barbara L.</creator><creator>Meliska, Charles J.</creator><creator>Sorenson, Diane L.</creator><creator>Martinez, L. Fernando</creator><creator>Lopez, Ana M.</creator><creator>Dawes, Sharron E.</creator><creator>Elliott, Jeffrey A.</creator><creator>Hauger, Richard L.</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20230301</creationdate><title>Critically-timed sleep+light interventions differentially improve mood in pregnancy vs. postpartum depression by shifting melatonin rhythms</title><author>Parry, Barbara L. ; Meliska, Charles J. ; Sorenson, Diane L. ; Martinez, L. Fernando ; Lopez, Ana M. ; Dawes, Sharron E. ; Elliott, Jeffrey A. ; Hauger, Richard L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3119-39bdf4a4fb4c8f977e9f13ea18dacef142ccca36d42ee62b74e08a966ed489383</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Affect</topic><topic>Chronotherapy</topic><topic>Circadian Rhythm</topic><topic>Depression, Postpartum - therapy</topic><topic>Female</topic><topic>Humans</topic><topic>Light treatment</topic><topic>Melatonin</topic><topic>Melatonin - therapeutic use</topic><topic>Peripartum depression</topic><topic>Pregnancy</topic><topic>Sleep</topic><topic>Wake therapy</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Parry, Barbara L.</creatorcontrib><creatorcontrib>Meliska, Charles J.</creatorcontrib><creatorcontrib>Sorenson, Diane L.</creatorcontrib><creatorcontrib>Martinez, L. Fernando</creatorcontrib><creatorcontrib>Lopez, Ana M.</creatorcontrib><creatorcontrib>Dawes, Sharron E.</creatorcontrib><creatorcontrib>Elliott, Jeffrey A.</creatorcontrib><creatorcontrib>Hauger, Richard L.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of affective disorders</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Parry, Barbara L.</au><au>Meliska, Charles J.</au><au>Sorenson, Diane L.</au><au>Martinez, L. Fernando</au><au>Lopez, Ana M.</au><au>Dawes, Sharron E.</au><au>Elliott, Jeffrey A.</au><au>Hauger, Richard L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Critically-timed sleep+light interventions differentially improve mood in pregnancy vs. postpartum depression by shifting melatonin rhythms</atitle><jtitle>Journal of affective disorders</jtitle><addtitle>J Affect Disord</addtitle><date>2023-03-01</date><risdate>2023</risdate><volume>324</volume><spage>250</spage><epage>258</epage><pages>250-258</pages><issn>0165-0327</issn><eissn>1573-2517</eissn><abstract>Testing the hypothesis that combined wake + light therapy improves mood in pregnant vs. postpartum depressed participants (DP) by differentially altering melatonin and sleep timing.
Initially 89 women, 37 pregnant (21 normal controls-NC; 16 DP) and 52 postpartum (27 NCs; 25 DP), were randomized to a parallel trial of a phase-delay intervention (PDI): 1-night of early-night wake therapy (sleep 3-7 am) + 6-weeks of evening bright white light (Litebook Advantage) for 60 min starting 90 min before bedtime, vs. a Phase-advance intervention (PAI): 1-night of late-night wake therapy (sleep 9 pm-1 am) + 6-weeks of morning bright white light for 60 min within 30 min of wake time. Blinded clinicians assessed mood weekly by structured interview, and participants completed subjective ratings, a Morningness-Eveningness questionnaire, actigraphy, and collected 2 overnight urine samples for 6-sulphatoxy melatonin (6-SMT).
In pregnant DP, mood improved more after the PDI vs. PAI (p = .016), whereas in postpartum DP, mood improved more after the PAI vs. PDI (p = .019). After wake therapy, 2 weeks of light treatment was as efficacious as 6 weeks (p > .05). In postpartum DP, PAI phase-advanced 6-SMT offset and acrophase (p < .05), which correlated positively with mood improvement magnitude (p = .003).
Small N.
Mood improved more after 2 weeks of the PDI in pregnant DP, but more after 2 weeks of PAI in postpartum DP in which improvement magnitude correlated with 6-SMT phase-advance. Thus, critically-timed Sleep + Light Interventions provide safe, efficacious, rapid-acting, well-tolerated, at-home, non-pharmaceutical treatments for peripartum DP.
•Melatonin rhythms are phase-advanced in pregnancy depression; phase-delayed in postpartum depression•Sleep+light interventions that phase-delay rhythms improve mood in pregnancy depression•Sleep+light interventions that phase-advance rhythms improve mood in postpartum depression•Sleep+light interventions benefit mood within 2 weeks•Sleep+light interventions can be administered at home</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>36586616</pmid><doi>10.1016/j.jad.2022.12.079</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Affect Chronotherapy Circadian Rhythm Depression, Postpartum - therapy Female Humans Light treatment Melatonin Melatonin - therapeutic use Peripartum depression Pregnancy Sleep Wake therapy |
| title | Critically-timed sleep+light interventions differentially improve mood in pregnancy vs. postpartum depression by shifting melatonin rhythms |
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