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Sleep homeostasis in alcohol-dependent, depressed and healthy control men

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Abstract

Visually scored and power spectral analyses (PSA) of polysomnography (PSG) recordings reveal abnormalities in alcohol dependence (AD) and major depressive disorder (MDD), including deficiencies in slow wave activity (SWA) during non-rapid eye movement (NREM) sleep. SWA parameters reflect the integrity of the homeostatic sleep drive, which have not been compared in those with AD or MDD. Ten men with AD were compared with 10 men with MDD and 10 healthy controls (HCs), all aged 20–40 years. They maintained an 11 pm to 6 am sleep schedule for 5–7 days, followed by 3 consecutive nights of PSG in the laboratory: night 1 for adaptation/screening; night 2 for baseline recordings; and night 3 as the challenge night, delaying sleep until 2 am. SWA was quantified with PSA across 4 NREM periods. Men with AD generated the least SWA at baseline. In response to sleep delay, HC men showed the expected SWA enhancement and a sharper exponential decline across NREM periods. Both the MDD and the AD groups showed a significantly blunted SWA response to sleep delay. Men with MDD had the least SWA in the first NREM period (impaired accumulation of sleep drive), whereas men with AD had the slowest SWA decay rate (impaired dissipation of sleep drive). These results suggest that both SWA generation and its homeostatic regulation are impaired in men with either AD or MDD. Finding interventions that selectively improve these different components of sleep homeostasis should be a goal of treatment for AD and MDD.

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References

  1. Giles DE, Jarrett RB, Roffwarg HP, Rush AJ (1987) Reduced rapid eye movement latency. A predictor of recurrence in depression. Neuropsychopharmacology 1(1):33–39

    Google Scholar 

  2. Armitage R (2007) Sleep and circadian rhythms in mood disorders. Acta Psychiatr Scand Suppl 115 (s433):104–115

    Google Scholar 

  3. Landolt HP, Gillin JC (2001) Sleep abnormalities during abstinence in alcohol-dependent patients. Aetiology and management. CNS Drugs 15(5):413–425

    Google Scholar 

  4. Roehrs T, Roth T (2001) Sleep, sleepiness, sleep disorders and alcohol use and abuse. Sleep Med Rev 5(4):287–297

    Article  PubMed  Google Scholar 

  5. Krystal AD, Thakur M, Roth T (2008) Sleep disturbance in psychiatric disorders: Effects on function and quality of life in mood disorders, alcoholism, and schizophrenia. Ann Clin Psychiatry 20(1):39–46

    Article  PubMed  Google Scholar 

  6. Brower KJ (2001) Alcohol’s effects on sleep in alcoholics. Alcohol Res Health 25:110–125

    PubMed  CAS  Google Scholar 

  7. Brower KJ (2003) Insomnia, alcoholism and relapse. Sleep Med Rev 7(6):523–539

    Article  PubMed  Google Scholar 

  8. Cohn TJ, Foster JH, Peters TJ (2003) Sequential studies of sleep disturbance and quality of life in abstaining alcoholics. Addict Biol 8(4):455–462

    Article  PubMed  CAS  Google Scholar 

  9. Tsuno N, Besset A, Ritchie K (2005) Sleep and depression. J Clin Psychiatry 66(10):1254–1269

    Article  PubMed  Google Scholar 

  10. Lam RW (2006) Sleep disturbances and depression: a challenge for antidepressants. Int Clin Psychopharmacol 21(Suppl 1):S25–S29

    Article  PubMed  Google Scholar 

  11. Benca RM, Obermeyer WH, Thisted RA, Gillin JC (1992) Sleep and psychiatric disorders: a meta-analysis. Arch Gen Psychiatry 49:651–668

    PubMed  CAS  Google Scholar 

  12. Armitage R (1995) Microarchitectural findings in sleep EEG in depression: diagnostic implications. Biol Psychiatry 37(2):72–84

    Article  PubMed  CAS  Google Scholar 

  13. Irwin M, Miller C, Gillin JC, Demodena A, Ehlers CL (2000) Polysomnographic and spectral sleep EEG in primary alcoholics: an interaction between alcohol dependence and African-American ethnicity. Alcohol Clin Exp Res 24:1376–1384

    Article  PubMed  CAS  Google Scholar 

  14. Colrain IM, Turlington S, Baker FC (2009) Impact of alcoholism on sleep architecture and EEG power spectra in men and women. Sleep 32(10):1341–1352

    PubMed  Google Scholar 

  15. Borbely AA, Achermann P (1999) Sleep homeostasis and models of sleep regulation. J Biol Rhythms 14(6):557–568

    PubMed  CAS  Google Scholar 

  16. Irwin M, Gillin JC, Dang J, Weissman J, Phillips E, Ehlers CL (2002) Sleep deprivation as a probe of homeostatic sleep regulation in primary alcoholics. Biol Psychiatry 51(8):632–641

    Article  PubMed  Google Scholar 

  17. Armitage R, Hoffmann RF (2001) Sleep EEG, depression and gender. Sleep Med Rev 5(3):237–246

    Article  PubMed  Google Scholar 

  18. Hasin DS, Stinson FS, Ogburn E, Grant BF (2007) Prevalence, correlates, disability, and comorbidity of DSM-IV alcohol abuse and dependence in the united states: Results from the national epidemiologic survey on alcohol and related conditions. Arch Gen Psychiatry 64(7):830–842

    Article  PubMed  Google Scholar 

  19. Prescott CA, Aggen SH, Kendler KS (2000) Sex-specific genetic influences on the comorbidity of alcoholism and major depression in a population-based sample of us twins. Arch Gen Psychiatry 57(8):803–811

    Article  PubMed  CAS  Google Scholar 

  20. Kuo PH, Neale MC, Walsh D, Patterson DG, Riley B, Prescott CA, Kendler KS (2010) Genome-wide linkage scans for major depression in individuals with alcohol dependence. J Psychiatr Res 44(9):616–619

    Article  PubMed  Google Scholar 

  21. Buysse DJ, Angst J, Gamma A, Ajdacic V, Eich D, Rossler W (2008) Prevalence, course, and comorbidity of insomnia and depression in young adults. Sleep 31(4):473–480

    PubMed  Google Scholar 

  22. Dombrovski AY, Cyranowski JM, Mulsant BH, Houck PR, Buysse DJ, Andreescu C, Thase ME, Mallinger AG, Frank E (2008) Which symptoms predict recurrence of depression in women treated with maintenance interpersonal psychotherapy? Depress Anxiety 25(12):1060–1066

    Article  PubMed  Google Scholar 

  23. Armitage R, Hoffmann R, Trivedi M, Rush AJ (2000) Slow-wave activity in nrem sleep: Sex and age effects in depressed outpatients and healthy controls. Psychiatry Res 95:201–213

    Article  PubMed  CAS  Google Scholar 

  24. Armitage R, Hoffmann R, Fitch T, Trivedi M, Rush AJ (2000) Temporal characteristics of delta activity during nrem sleep in depressed outpatients and healthy adults: Group and sex effects. Sleep 23(5):607–617

    PubMed  CAS  Google Scholar 

  25. First MB, Spitzer RL, Gibbon M, Williams JBW (eds) (1997) Structured clinical interview for DSM-IV axis I disorders (SCID-I), clinician version: User’s guide. American Psychiatric Press, Washington, D.C

    Google Scholar 

  26. Kranzler HR, Kadden RM, Babor TF, Tennen H, Rounsaville BJ (1996) Validity of the SCID in substance abuse patients. Addiction 91:859–868

    Article  PubMed  CAS  Google Scholar 

  27. American Psychiatric Association (2000) DSM-IV-TR: diagnostic and statistical manual of mental disorders, 4th edn, text revision. American Psychiatric Association, Washington DC

    Book  Google Scholar 

  28. Hamilton M (1960) A rating scale for depression. J Neurol Neurosurg Psychiatry 23:56–62

    Article  PubMed  CAS  Google Scholar 

  29. Maisto SA, Sobell MB, Cooper AM, Sobell LC (1979) Test-retest reliability of retrospective self-reports in three populations of alcohol abusers. J Behav Assess 1:315–326

    Article  Google Scholar 

  30. Sobell LC, Sobell MB, Leo GI, Cancilla A (1988) Reliability of a timeline method: Assessing normal drinkers’ reports of recent drinking and a comparative evaluation across several populations. Br J Addiction 83:393–402

    Article  CAS  Google Scholar 

  31. Anton RF, Moak DH, Latham PK (1996) The obsessive compulsive drinking scale: a new method of assessing outcome in alcoholism treatment studies. Arch Gen Psychiatry 53:225–231

    PubMed  CAS  Google Scholar 

  32. Miller WR, Tonigan JS, Longabaugh RL (1995) The drinker inventory of consequences (DrInc): an instrument for assessing adverse consequences of alcohol abuse, vol 4. Project match monograph series. National Institutes of Health (Publication No. 95-3911), Rockville, MD

  33. Sobell LC, Maisto SA, Sobell MB, Cooper AM (1979) Reliability of alcohol abuser’s self-reports of drinking behavior. Behavioral Research and Therapy 17:157–160

    Article  CAS  Google Scholar 

  34. Rechtschaffen A, Kales AA (eds) (1968) A manual of standardized terminology, techniques and scoring system for sleep stages of human subjects. Government Printing Office (NIH Publication No. 204), Washington, DC

  35. Press WH, Flannery BP, Teukolosky SA, Bettering WT (1989) Numerical recipes in pascal. Cambridge University Press, New York

    Google Scholar 

  36. Dijk DJ, Beersma DG, Daan S (1987) EEG power density during nap sleep: reflection of an hourglass measuring the duration of prior wakefulness. J Biol Rhythms 2(3):207–219

    Article  PubMed  CAS  Google Scholar 

  37. Dijk DJ, Beersma DG, Daan S, Bloem GM, Van den Hoofdakker RH (1987) Quantitative analysis of the effects of slow wave sleep deprivation during the first 3 h of sleep on subsequent EEG power density. Eur Arch Psychiatry Neurol Sci 236(6):323–328

    Article  PubMed  CAS  Google Scholar 

  38. Dijk DJ, Beersma DG, Bloem GM (1989) Sex differences in the sleep EEG of young adults: visual scoring and spectral analysis. Sleep 12(6):500–507

    PubMed  CAS  Google Scholar 

  39. Dijk DJ, Beersma DG, van den Hoofdakker RH (1989) All night spectral analysis of EEG sleep in young adult and middle-aged male subjects. Neurobiol Aging 10(6):677–682

    Article  PubMed  CAS  Google Scholar 

  40. Dijk DJ, Brunner DP, Beersma DG, Borbely AA (1990) Electroencephalogram power density and slow wave sleep as a function of prior waking and circadian phase. Sleep 13(5):430–440

    PubMed  CAS  Google Scholar 

  41. Dijk DJ, Brunner DP, Borbely AA (1990) Time course of EEG power density during long sleep in humans. Am J Physiol 258 (3 Pt 2):R650–661

    Google Scholar 

  42. Dijk DJ (1999) Circadian variation of EEG power spectra in NREM and REM sleep in humans: dissociation from body temperature. J Sleep Res 8(3):189–195

    Article  PubMed  CAS  Google Scholar 

  43. Feinberg I, March JD, Fein G, Floyd TC, Walker JM, Price L (1978) Period and amplitude analysis of 0.5–3 c/sec activity in nrem sleep of young adults. Electroencephalogr Clin Neurophysiol 44 (2):202–213

    Google Scholar 

  44. Stein MD, Friedmann PD (2006) Disturbed sleep and its relationship to alcohol use. Subst Abus 26(1):1–13

    Article  Google Scholar 

  45. Arnedt JT, Conroy DA, Brower KJ (2007) Treatment options for sleep disturbances during alcohol recovery. J Addict Dis 26(4):41–54

    Article  PubMed  Google Scholar 

  46. Roth T (2009) Does effective management of sleep disorders reduce substance dependence? Drugs 69(Suppl 2):65–75

    Article  PubMed  CAS  Google Scholar 

  47. Friedmann PD, Herman DS, Freedman S, Lemon SC, Ramsey S, Stein MD (2003) Treatment of sleep disturbance in alcohol recovery: a national survey of addiction medicine physicians. J Addict Dis 22(2):91–103

    Article  PubMed  Google Scholar 

  48. Brower KJ, Myra Kim H, Strobbe S, Karam-Hage MA, Consens F, Zucker RA (2008) A randomized double-blind pilot trial of gabapentin versus placebo to treat alcohol dependence and comorbid insomnia. Alcohol Clin Exp Res 32:1429–1438

    Article  PubMed  CAS  Google Scholar 

  49. Gillin JC, Smith TL, Irwin M, Kripke DF, Brown S, Schuckit M (1990) Short REM latency in primary alcoholic patients with secondary depression. Am J Psychiatry 147:106–109

    PubMed  CAS  Google Scholar 

  50. Moeller FG, Gillin JC, Irwin M, Golshan S, Kripke DF, Schuckit M (1993) A comparison of sleep EEGs in patients with primary major depression and major depression secondary to alcoholism. J Affect Disord 27(1):39–42

    Article  PubMed  CAS  Google Scholar 

  51. Clark CP, Gillin JC, Golshan S, Demodena A, Smith TL, Danowski S, Irwin M, Schuckit M (1999) Polysomnography and depressive symptoms in primary alcoholics with and without a lifetime diagnosis of secondary depression and in patients with primary major depression. J Affect Dis 52(1–3):177–185

    Article  PubMed  CAS  Google Scholar 

  52. Gann H, van Calker D, Feige B, Cloot O, Bruck R, Berger M, Riemann D (2004) Polysomnographic comparison between patients with primary alcohol dependency during subacute withdrawal and patients with a major depression. Eur Arch Psychiatry Clin Neurosci 254(4):263–271

    PubMed  Google Scholar 

  53. Gillin JC, Smith TL, Irwin M, Butters N, Demodena A, Schuckit M (1994) Increased pressure for rapid eye movement sleep at time of hospital admission predicts relapse in nondepressed patients with primary alcoholism at 3-month follow-up. Arch Gen Psychiatry 51:189–197

    PubMed  CAS  Google Scholar 

  54. Gann H, Feige B, Hohagen F, van Calker D, Geiss D, Dieter R (2001) Sleep and the cholinergic rapid eye movement sleep induction test in patients with primary alcohol dependence. Biol Psychiatry 50(5):383–390

    Article  PubMed  CAS  Google Scholar 

  55. Feige B, Scaal S, Hornyak M, Gann H, Riemann D (2007) Sleep electroencephalographic spectral power after withdrawal from alcohol in alcohol-dependent patients. Alcohol Clin Exp Res 31(1):19–27

    Article  PubMed  Google Scholar 

  56. Brower KJ, Hall JM (2001) Effects of age and alcoholism on sleep: a controlled study. J Stud Alcohol 62(3):335–343

    PubMed  CAS  Google Scholar 

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Acknowledgments

This work was supported by National Institutes of Health grants 2 K24 AA00304-10 and R01 AA016117-04 to KJB and R01 MH61515 to RA.

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The authors report no conflicts of interest.

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Correspondence to Kirk J. Brower.

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Brower, K.J., Hoffmann, R., Conroy, D.A. et al. Sleep homeostasis in alcohol-dependent, depressed and healthy control men. Eur Arch Psychiatry Clin Neurosci 261, 559–566 (2011). https://doi.org/10.1007/s00406-011-0195-5

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  • DOI: https://doi.org/10.1007/s00406-011-0195-5

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