SLEEP IN DEPRESSION AND OTHER PSYCHIATRIC-DISORDERS

Subjective and objective sleep disturbances are common in nearly all psychiatric disorders. Some objective sleep abnormalities, such as short REM latency and loss of stage 3 and 4 sleep, occur in patients with depression, but also in those with other disorders. Further studies are still needed to prove the diagnostic importance of specific sleep abnormalities. In particular, the antidepressant effects of sleep deprivation and the mood altering effects of sleep in sleep-deprived patients remain the most predictable nonpharmacological manipulations of mood in depression. Sleep measures also have promising prognostic value. For example, persistent insomnia may predict the development of depression; short REM latency may predict the response to antidepressant therapies or intermediate-term relapse; short REM latency and increased REM% may predict intermediate-term relapse in nondepressed, primary alcoholic patients. It is also possible that short REM latency or other sleep measures may be genetic markers associated with depression within families. As knowledge of the neurobiology of sleep and chronobiology increases, sleep measures will provide heuristic clues to the pathophysiology of psychiatric disorders that manifest specific sleep abnormalities. (C) 1993 Wiley-Liss, Inc.