Can depression be helped by a novel treatment involving sleep deprivation? Our latest study shows this is a promising area for further research.
The study looked at triple chronotherapy, also known as Wake and Light Therapy. In brief this is a treatment involving sleep deprivation for 36 hours, followed by 4 days of advancing the time of sleep, and bright light therapy every morning. While this might sound an unusual approach to treating depression, an advantage it seems to have over many other treatments is its potential to obtain rapid improvement for patients within a few days.
We conducted a relatively small control trial to investigate whether it’s possible to deliver the triple chronotherapy in outpatients. And we found it was. It produced a significant and rapid benefit after 1 week in out-patients with depression, that was sustained at 26 weeks.
Our trial was limited by being unable to offer the therapy immediately after people were randomly sorted into the treatment and control groups. So we had several dropouts before it was delivered. This led to a lower response rate in our intention to treat statistical analysis. Of those that received the treatment the proportion of ‘responders’ – meaning people who experienced at least 50% reduction in symptoms – was 52% in the triple chronotherapy. This compares with 18% in the control group at week 1.
The problem is we don’t really know yet who benefits. In our trial, we excluded people with chronic depression , i.e. lasting more than 2 years. And the data suggests that it does not help with ruminating (over-thinking).
So while our study adds to the literature on triple chronotherapy, there is a need for greater funding in this area. We learnt a lot from this study and would now like to conduct a larger cost effectiveness multi-centre trial with up to 300 participants. It will be several years before we obtain the funding, conduct the study, and publish it. And then we’d need to have our findings incorporated in NICE Guidelines for depression before it could eventually be offered as a routine intervention by the NHS or charities.
In the meantime – watch this space. And please contact me if you’re a philanthropist willing to fund a study to explore whether Wake and Light Therapy can treat many people with depression in a single event at night.
Practical details on delivery of triple chronotherapy (also known as Wake and Light Therapy) can be found on my website here.
Our previous meta-analysis of in-patient triple chronotherapy suggesting benefit can be found here.