Sleep Deprivation as a Treatment for Depression: Comparison of mood ratings and improving prediction of treatment response

Major Depressive Disorder (MDD), a major contributor to disability and disease burden, is a critical public health issue. Typical treatments for MDD include pharmacotherapy and office-based therapy. However, fewer than 60% of those with MDD respond to a single course of these treatments, and the relapse rate is nearly 50%. In contrast, acute sleep deprivation therapy (SD) yields an antidepressant effect in \u3c 24 hours with comparable response rates. Clinical practice has not widely adopted the use of SD due in-part to its transient effects and inconvenience to patients. This study examined the utility self-administered baseline PANAS, POMS-SF, and VAS mood measures and baseline demographics to predict a participant’s response to SD. Depressed participants (N = 37) underwent ~36 hr of sleep deprivation. An antidepressant response was defined as a ≥ 30% decrease in HDRS-NOW score from baseline to post-sleep deprivation. Odds ratios of experiencing a response were calculated utilizing univariate binary logistic regression. 64% (n = 23) of participants responded to SD. Identifying as white OR = 5.14, p = .030, 95% CI [1.19, 22.48], being employed OR = 4.53, p = .042, 95% CI [1.06, 19.41], and greater scores on the baseline PANAS positive affect scale OR = 1.30, p = .010, 95% CI [ 1.07, 1.59], were significantly associated with the odds of experiencing an antidepressant response to SD. To our knowledge, the PANAS positive affect scale has not been previously identified as a predictor of response to SD. The results of this research may be utilized to inform and ease screening for this treatment modality in the clinical and research settings