The Origin of Early REM Sleep Episodes in Depression and other Conditions
Normal sleep onset in the human adult is characterized by a transition from wakefulness to non-REM sleep. There is a progression of the sleep stages 1 — 2 — 3 — 4, which is ended after about an hour by the emergence of the first REM sleep episode. Numerous studies have shown that this basic structure of the first sleep cycle is significantly altered in many nights of depressed patients. As Kupfer and coworkers have shown, REM latency is abbreviated during depression (Kupfer, 1976). In addition, the amount of slow wave sleep stages 3 and 4 may be reduced by the illness (Gillin et al., 1979). While a reduction of slow wave sleep has also been observed in other patient samples and in healthy subjects of advanced age, short REM latency has been claimed to be more specific and to represent a biological marker of primary depression (Kupfer, 1976). However, specificity of short REM latency as a marker for depression has been challenged by the fact that short REM sleep latencies may also occur in normal aged subjects (Spiegel, 1981) and in patients with different psychiatric diseases (Jus et al., 1973; Insel et al., 1982). In addition, sleep onset REM episodes (SOREM, latency ≦ 20 minutes after sleep onset) have been observed after a shift of the regular sleep time (Decoster and Foret, 1979), after a reduction of sleep time (Mullaney et al., 1977), in nap studies (Karacan et al., 1970), and in subjects living on an ultradian rest-activity schedule (Weitzman et al., 1974).
KeywordsDepressed Patient Sleep Onset Slow Wave Sleep Body Core Temperature Total Sleep Deprivation
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