Neural Mechanisms Underlying the Antidepressant Effects of Sleep Deprivation
It has long been known that sleep deprivation improves mood in 50-60% of people with depression but it is not known how this works in the brain. The purpose of this study is to better understand how one night of sleep deprivation affects mood in people with depression using brain imaging by comparing individuals with current depression and healthy controls with no history of depression.
If you agree to participate your participation will involve two visits. Both visits will take place at the Center for Human Phenomic Science (CHPS) at the Hospital of the University of Pennsylvania. Visit 1 You will first attend a 3-hour screening session. You and the study staff will discuss the study details, review the information in the informed consent form. You will then complete some questionnaires about your sleep, thoughts and feelings. You will also have an interview that will include questions about your psychiatric, medical and sleep history. You will be asked to provide a urine sample. The urine samples will be tested for traces of drugs and to ensure that you are healthy. These data will be used to establish that you are eligible to participate in this study and as background information. If you are a woman, your urine sample will also be tested to see if you are pregnant. If you are currently taking any medications for depression or other mental health problems, you will need to stop taking these medications for 2 weeks (4 weeks if taking fluoxetine) before continuing in the study and wait until the study is completed to start taking them again. A study psychiatrist will discuss going off medication with you and with the provider prescribing the medication. Home sleep monitoring At the end of this screening session, you will have your sleep monitored at home for 1 week. You will receive a portable sleep monitoring device to wear in your home while you sleep for one night. You will also receive sleep diaries to complete at home, which take about 5 minutes twice each day. Furthermore, your activity patterns at home will be monitored by a small device worn on your wrist called a “wrist actigraph” (which is about the size of a wrist watch). The actigraph measures your patterns of movement and is a way to estimate your sleep patterns. You will be asked to fill out the sleep diaries and to wear the wrist actigraph for 7 days, and then either return all sleep recording equipment to us in person or mail it to us in a pre-paid envelope. If there is evidence of sleep disorders from this monitoring you will not be able to continue participating in the study. If there is no evidence of sleep disorders you will be scheduled for the next visit within 1 week. Visit 2 For this visit you will come to the CHPS at 4:00 PM and be checked into the hospital for a 5-day, 4-night period, where you will remain in a temperature-controlled, isolated environment with a fixed low level of lighting with up to one other subject. You will not be able to attend work or classes. The environment you will live in during the laboratory phase will be shielded from external influences. In addition, nutritionally balanced meals will be provided to you. You will be allowed to drink as much water as you want. You will have to refrain from caffeine, alcohol and smoking. Throughout the laboratory phase of the study, we will schedule your daily activities (sleeping, eating, etc.) and nurses will be present to monitor your activities. Each night, your brain and heart activity will be recorded by means of electrodes attached to the skin. Small electrodes will be placed on the skin of the scalp, face, chin, and chest region. The scalp electrodes will be held in place by a special paste, which can be removed with warm water. If you are found to have any sleep disorders on the first night of monitoring you will be withdrawn from the study. Throughout the entire study, your physical activity will be monitored by a wrist actigraph, like the one you were wearing at home before the study. On nights 1 and 2 of the protocol, you will be allowed to sleep for 9 hours, going to bed at 10:00pm. During the day you will be free to watch television or video tapes, talk to or play games with the other subject or with our staff, read, or undertake other non-vigorous activities, but not work or play games on a computer. Starting on day 3 you will then stay awake for approximately 36 hours. The following night (night 4) you will have a 12 hour sleep opportunity (7:00 PM-7:00 AM). The experiment will end at 5pm on day 5 of the experiment, and you will be allowed to leave the lab at this time. There will be a short debriefing session before you leave the lab so that we may get your feedback and allow you to ask any questions you may have. On the mornings of Days 2-5 a study staff member will ask you questions about your mood. During the time you are awake each day you will complete about 30 minutes of computerized cognitive tasks every 4 hours, with a short 10-minute task in between these times. You will also complete mood ratings every two hours on Days 3 and 4. You will undergo 3 fMRI (brain) scans, on the morning of days 3, 4 and 5 of the protocol. The procedure for these scans is described in detail below. These scans will last approximately one hour, and will take place between 8 and 10 am. Two of these scans will take place while you are rested, and the other while you are sleep-deprived. After the MRI scanning, you will be given an opportunity to take a shower. You will have a blood draw (about 2 tablespoons) on the mornings of days 2, 4, and 5. The blood samples will be used to see if any chemicals in blood change as a result of the sleep deprivation.
- Study Identifier: 824403