Biological and behavioral effects of one night's sleep deprivation in depressed patients and normals

Twenty-five patients with major depressive illness and 20 normal volunteers were sleep deprived for one night in order to assess mood, physiology, and biochemistry. Fifteen patients showed mild to moderate improvement in depression, normally lasting one day, while volunteers tended to experience slight increases in dysphoria following sleep deprivation (SD). Prior to SD depressed patient responders had lower baseline levels of HVA in CSF than non-responders. Following SD responders tended to have decreases in CSF calcium and MHPG and increases in serum cortisol compared to nonresponders. Nonresponders also showed a flattened diurnal temperature rhythm following SD. Alterations in central neurotransmitters, circadian rhythms, and stress activation are discussed as possible mediators of the selective mood improvement in depressed patients compared to normal volunteer controls.