Original article| Volume 40, ISSUE 6, P485-496, September 15, 1996

Download started.


Sleep electroencephalogram in seasonal affective disorder and in control women: Effects of midday light treatment and sleep deprivation

      This paper is only available as a PDF. To read, Please Download here.
      The role of sleep regulation in Seasonal Affective Disorder (SAD) was studied in 11 female SAD patients and eight controls in winter before and after light treatment (LT, 6000 lux, 10–14h, 5 days). The sleep electroencephalogram (EEG) was recorded at baseline and after the total sleep deprivation (TSD) of a 40-h constant routine. The well-known effects of TSD on sleep parameters and on EEG power spectra were replicated, indicating normal homeostatic sleep regulation in SAD. Sleep improved after LT in both groups. Since the condition following LT was the second session, these improvements may be an order effect and/or an effect of LT itself. After LT, sleep EEG spectra of SAD patients, but not of controls, showed modifications resembling those of recovery sleep. Since only SAD patients curtailed their sleep while remitting during the LT period, these EEG modifications can be explained by normal sleep regulation alone. We conclude that the robust antidepressant effect of LT in SAD is unlikely to be mediated by changes in sleep, and that sleep regulatory mechanisms are not a crucial factor in the pathogenesis of winter depression.

      Key Words

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Biological Psychiatry
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Aitken RCB
        Measurement of feelings using visual analogue scales.
        in: Proc Royal Soc Med. 62. 1969: 17-21
        • Anderson JL
        • Rosen LN
        • Mendelson WB
        • Jacobsen FM
        • Skwerer RG
        • Joseph-Vanderpool JR
        • Duncan CC
        • Wehr TA
        • Rosenthal NE
        Sleep in fall/winter seasonal affective disorder: effects of light and changing seasons.
        J Psychosom Res. 1994; 38: 323-337
        • Benca RM
        • Obermeyer WH
        • Thisted RA
        • Gillin JC
        Sleep and psychiatric disorders: a meta-analysis.
        Arch Gen Psychiatry. 1992; 49: 651-668
        • Berger RJ
        • Walker JM
        • Scott TD
        • Magnuson LJ
        • Pollack SL
        Diurnal and nocturnal sleep stage patterns following sleep deprivation.
        Psychonomic Science. 1971; 23: 273-275
        • Bonnet MH
        Effect of 64 hours of sleep deprivation upon sleep in geriatric normals and insomniacs.
        Neurobiol Aging. 1986; 7: 89-96
        • Borbély AA
        • Baumann F
        • Brandeis D
        • Strauch I
        • Lehmann D
        Sleep deprivation: Effect on sleep stages and EEG power density in man.
        Electroenceph Clin Neurophysiol. 1981; 51: 483-493
        • Borbély AA
        • Wirz-Justice A
        Sleep, sleep deprivation, and depression.
        Human Neurobiol. 1982; 1: 205-210
        • Brunner DP
        • Dijk DJ
        • Tobler I
        • Borbély AA
        Effect of partial sleep deprivation on sleep stages and EEG power spectra: Evidence for nonREM and REM sleep homeostasis.
        Electroenceph Clin Neurophysiol. 1990; 75: 492-499
        • Brunner DP
        • Dijk DJ
        • Borbély AA
        Repeated partial sleep deprivation progressively changes the EEG during sleep and wakefulness.
        Sleep. 1993; 16: 100-113
        • Brunner DP
        • Kräuchi K
        • Leonhardt G
        • Graw P
        • Wirz-Justice A
        Sleep parameters in SAD: Effects of midday light, season, and sleep deprivation.
        Sleep Res. 1993; 22: 396
        • Campbell SS
        • Dawson D
        • Anderson MW
        Alleviation of sleep maintenance insomnia with timed exposure to bright light.
        J Am Geriatr Soc. 1993; 41: 829-836
        • Carrier J
        • Dumont M
        Sleep propensity and sleep architecture after bright light exposure at three different times of day.
        J. Sleep Res. 1995; 4: 202-211
        • Czeisler CA
        • Weitzman ED
        • Moore-Ede MC
        • Zimmerman JC
        • Knauer RS
        Human sleep: Its duration and organization depend on its circadian phase.
        Science. 1980; 210: 1264-1267
        • Czeisler CA
        • Kronauer RE
        • Mooney JJ
        • Anderson JL
        • Allan JS
        Biologic rhythm disorders, depression, and phototherapy: A new hypothesis.
        Psy Clin N Amer. 1987; 10: 687-709
        • Czeisler CA
        • Kronauer RE
        • Allan JS
        • Duffy JF
        • Jewett ME
        • Brown EN
        • Ronda JM
        Bright light induction of strong (type 0) resetting of the human circadian pacemaker.
        Science. 1989; 244: 1328-1333
        • Dijk DJ
        • Czeisler CA
        Body temperature is elevated during the rebound of slow-wave sleep following 40-h of sleep deprivation on a constant routine.
        J Sleep Res. 1993; 2: 117-120
        • Dijk DJ
        • Beersma DGM
        • Daan S
        Bright morning light advances the human circadian system without affecting NREM sleep homeostasis.
        Am J Physiol. 1989; 256: R106-R111
        • Dijk DJ
        • Brenner DP
        • Borbély AA
        Time course of EEG power density during long sleep in humans.
        Am J Physiol. 1990; 258: R650-R661
        • Dijk DJ
        • Hayes B
        • Czeisler CA
        Dynamics of electroencephalographic sleep spindles and slow wave activity in men: effect of sleep deprivation.
        Brain Res. 1993; 626: 190-199
        • Eastman CI
        • Young MA
        • Fogg LF
        A comparison of two different placebo-controlled SAD light treatment studies.
        in: Wetterberg L Light and Biological Rhythms in Man. Pergamon Press, New York, NY1993: 371-383
        • Endo T
        Morning bright light effects on circadian rhythms and sleep structure of SAD.
        Jikeikai Med J. 1993; 40: 295-307
        • Feinberg I
        • Maloney T
        • March JD
        Precise conservation of NREM period 1 (NREMP1) delta across naps and nocturnal sleep: Implications for REM latency and NREM/REM alternation.
        Sleep. 1992; 15: 400-403
        • Gillin JC
        • Duncan WC
        • Pettigrew KD
        • Frankel BL
        • Snyder F
        Successful separation of depressed, normal, and insomniac subjects by EEG sleep data.
        Arch Gen Psychiatry. 1979; 36: 85-90
        • Hamilton M
        Development of a rating scale for primary depressive illness.
        Br J Soc Clin Psychol. 1967; 6: 278-296
        • Haug HJ
        • Fähndrich E
        Problems in defining response in therapy studies.
        Pharmacopsychiat. 1986; 19: 170-171
      1. (in press)
        • Haug HJ
        • Wirz-Justice A
        • Kräuchi K
        • Graw P
        • Hetsch C
        • Leonhardt G
        • Brenner DP
        Circadiane Veränderungen der Stimmung bei Depressiven und Gesunden während einer “Constant-Routine”-Untersuchung.
        in: Möller HJ Müller-Spahn F Kurtz G Biologische Psychiatrie 1994. Springer Verlag, Oxford1996
        • Kohsaka M
        • Honma H
        • Fukuda N
        • Kobayashi R
        • Honma K
        Does bright light change sleep structures in seasonal affective disorder?.
        Soc Light Treatment Biol Rhythms (Abstr). 1994; 6: 32
        • Kräuchi K
        • Wirz-Justice A
        • Graw P
        High intake of sweets late in the day predicts a rapid and persistent response to light therapy in winter depression.
        Psychiatry Res. 1993; 46: 107-117
        • Kuhs H
        • Toelle R
        Sleep deprivation therapy.
        Biol Psychiatry. 1991; 29: 1129-1148
        • Lewy AJ
        • Sack R
        • Miller L
        • Hoban T
        Antidepressant and circadian phase-shifting effects of light.
        Science. 1987; 235: 352-354
        • Meesters Y
        • Jansen JHC
        • Lambers PA
        • Bouhuys AL
        • Beersma DGM
        • Van den Hoofdakker RH
        Morning and evening light treatment of seasonal affective disorder: Response, relapse and prediction.
        J Affect Disord. 1993; 28: 165-177
        • Palchikov VE
        • Zolotarev DY
        • Danilenko KV
        • Putilov AA
        Effects of the seasons and of bright light administered at different times of day on sleep EEG and mood in patients with seasonal affective disorder.
        Biol Rhythm Res. 1996; (in press)
        • Partonen T
        • Appelberg B
        • Partinen M
        Effects of light treatment on sleep structure in seasonal affective disorder.
        Eur Arch Psychiatry Clin Neurosci. 1993; 242: 310-313
        • Putilov AA
        • Danilenko KV
        • Palchikov VE
        • Schergin SM
        The multiple sleep latency test in seasonal affective disorder: no evidence for increased sleep propensity.
        Soc Light Treatment Biol Rhythms (Abstr). 1995; 7: 30
      2. (National Institutes of Health, Publication No. 204)
        • Rechtschaffen A
        • Kales A
        A Manual of Standardized Terminology, Techniques, and Scoring System for Sleep Stages of Human Subjects. U.S. Government Printing Office, Wien1968
        • Reynolds CF
        • Kupfer DJ
        Sleep research in affective illness: State of the art circa 1987.
        Sleep. 1987; 10: 199-215
        • Reynolds CF
        • Kupfer DJ
        • Hoch CC
        • Stack JA
        • Houck PR
        • Berman SR
        Sleep deprivation in healthy elderly men and women: Effects on mood and on sleep during recovery.
        Sleep. 1986; 9: 492-501
        • Rosen LN
        • Targum SD
        • Terman M
        • Bryant MJ
        • Hoffman H
        • Kasper SF
        • Hamovit JR
        • Docherty JP
        • Welch B
        • Rosenthal NE
        Prevalence of seasonal affective disorder at four latitudes.
        Psychiatry Res. 1990; 31: 131-144
        • Rosenthal NE
        • Sack DA
        • Gillin JC
        • Lewy AJ
        • Goodwin FK
        • Davenport Y
        • Mueller PS
        • Newsome DA
        • Wehr TA
        Seasonal Affective Disorder: A description of the syndrome and preliminary findings with light therapy.
        Arch Gen Psychiatry. 1984; 41: 72-80
        • Rosenthal NE
        • Skwerer RG
        • Levendosky BA
        • Joseph-Vanderpool JR
        • Jacobsen FM
        • Duncan CC
        • Gaist PA
        • Wehr TA
        Sleep architecture in seasonal affective disorder: The effects of light therapy and changing seasons.
        Sleep Res. 1989; 18: 440
        • Shapiro CM
        • Devins GM
        • Feldman B
        • Levitt AJ
        Is Hypersomnolence a feature of seasonal affective disorder?.
        J Psychosom Res. 1994; 38: 49-54
        • Society of Light Treatment and Biological Rhythms
        Consensus statement on the efficacy of light treatment for SAD.
        LTBR. 1990; 3: 5-9
        • Terman M
        Problems and prospects for use of bright light as a therapeutic intervention.
        in: Wetterberg L Light and Biological Rhythms in Man. Pergamon Press, Washington, DC1993: 421-436
        • Terman M
        • Terman JS
        Seasonal Affective Disorder and Light Therapy: Report to the Depression Guidelines Panel.
        P.H.S. Agency for Health Care Policy and Research, Oxford1991
        • Terman M
        • Terman JS
        • Quitkin FM
        • McGrath PJ
        • Stewart JW
        • Rafferty B
        Light therapy for seasonal affective disorder: A review of efficacy.
        Neuropsychopharmacol. 1989; 2: 1-22
        • Thase ME
        Comparison between seasonal affective disorder and other forms of recurrent depression.
        in: Rosenthal NE Blehar MC Seasonal Affective Disorders and Phototherapy. Guilford Press, New York1989: 64-78
        • Wehr TA
        • Rosenthal NE
        • Sack DA
        Environmental and behavioral influences on affective illness.
        Acta Psychiat Scand. 1988; 77: 44-52
        • Werth E
        • Dijk DJ
        • Achermann P
        • Borbély AA
        Effect of an early evening nap on sleep and the sleep EEG.
        J Sleep Res. 1994; 3: 276
        • Williams RL
        • Karacan I
        • Hursch CJ
        Electroencephalography (EEG) of Human Sleep: Clinical Applications.
        John Wiley & Sons, New York1974
        • Wirz-Justice A
        A decade of light therapy for seasonal affective disorder.
        in: Jung EG Holick MF Biological Effects of Light. Walter de Gruyter, New York1994: 192-205
        • Wirz-Justice A
        Biological rhythms in mood disorders.
        in: Bloom FE Kupfer DJ Psychopharmacology. The Fourth Generation of Progress. Raven Press, Berlin1994: 999-1017
        • Wirz-Justice A
        • Anderson JL
        Morning light exposure for the treatment of winter depression: the one true light therapy?.
        Psychopharmacol Bull. 1990; 26: 511-520
        • Wirz-Justice A
        • Graw P
        • Kräuchi K
        • Pöldinger W
        Phototherapy in Switzerland: “Mehr Licht”.
        in: Thompson C Silverstone T Seasonal Affective Disorder. CNS Publishers, New York1989: 169-185
        • Wirz-Justice A
        • Graw P
        • Kräuchi K
        • Gisin B
        • Jochum A
        • Arendt J
        • Fisch HU
        • Buddeberg C
        • Pöldinger W
        Light therapy in seasonal affective disorder is independent of time of day or circadian phase.
        Arch Gen Psychiatry. 1993; 50: 929-937
        • von Zerssen D
        • Koeller DM
        Beltz Testgesellschaft, London1976
        • Zulley J
        • Wever R
        • Aschoff J
        The dependence of onset and duration of sleep on the circadian rhythm of rectal temperature.
        Plügers Arch. 1981; 391: 314-318