Work

Meta‐analysis of sleep deprivation in the acute treatment of bipolar depression

Year: 2020

Type: review

Study designs: Systematic Review, Meta-Analysis

Abstract: BACKGROUND: Sleep deprivation (SD) is an antidepressant intervention with multiple administration formats that has been investigated primarily with uncontrolled clinical trials and qualitative reviews of the literature. The validity and applicability of these findings to the treatment of bipolar depression (BPD) is uncertain. METHODS: A PRISMA-based systematic review of the literature and meta-analysis were conducted to determine the efficacy of SD in the treatment of BPD and to identify moderator variables that influence response rate. RESULTS: From a sample of 15 studies covering 384 patients, the overall, mean response rate to SD was 47.6% (CI 36.0%, 59.5%). This response rate compared post-SD to pre-SD depression scores, and not to a placebo control condition. Of several potential moderating variables examined, the use of adjunctive pharmacotherapy achieved statistical significance with response rates of 59.4% [CI 48.5, 69.5] for patients using adjunctive medication vs 27.4% [CI 17.8, 39.8] for patients not using adjunctive medication. CONCLUSIONS: This meta-analysis of SD in the treatment of BPD found an overall, response rate of almost 50%, reinforcing earlier estimates of efficacy. The use of adjunctive pharmacotherapy had a statistically significant moderating effect on SD response suggesting that clinical practice should routinely pair these interventions. These findings provide a higher level of evidence supporting the use of SD, especially when used with medication, and should inform future management guidelines for the treatment of BPD.

Source: Acta Psychiatrica Scandinavica

DOI: 10.1111/acps.13255

Authors: John F. Gottlieb, Namni Goel, Shenghao Chen, Michael A. Young

Institutions: Northwestern University, Rush University Medical Center, Florida State University, Illinois Institute of Technology

Language: English

Topic: Bipolar Disorder and Treatment

Subfield: Psychiatry and Mental health

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: green

Funders: Foundation for the National Institutes of Health, National Aeronautics and Space Administration, National Institute of Diabetes and Digestive and Kidney Diseases