For many patients with depression, their mood significantly improves after a night’s sleep. However, after entering the next sleep phase, the effects often dissipate, making it difficult to shorten the time it takes for medication or psychotherapy to take effect. Therefore, researchers led by psychiatrist David Veale from King’s College London and psychologist Clara Humpston from the University of Birmingham studied the combination of sleep deprivation with two other short-term measures. The results of this trial showed that under this “triple timing therapy,” about two-thirds of patients experienced improved health after a week. In contrast, only 1.5% of patients receiving medication and/or psychotherapy reported feeling better.
The “triple timing therapy” (sleep deprivation, sleep phase shift, and/or the use of bright light) combines non-invasive and non-pharmacological interventions to rapidly alleviate depressive symptoms.
During depressive episodes, the normal waking rhythm is often disrupted, particularly in those struggling with sleep disorders. Repeated awakenings at night disrupt the natural rhythm of sleep; however, after the “timing therapy,” sleep returns to a more regular state. One patient undergoing this therapy followed this sleep pattern: the first night’s sleep lasted from 6 PM to 1 AM, the second night from 8 PM to 3 AM, and the third sleep from 10 PM to 5 AM.
In the therapy, to ensure that patients with depression feel tired and drowsy in a timely manner, subjects are required to wear blue filters in the evening to shield them from sunlight. In the morning, they need to sit about 30 centimeters away from a 10,000 lux daylight lamp for approximately half an hour.
In 16 studies (4 randomized controlled trials and 12 open-label case series), subjects were compared between all experimental and control conditions. The results showed that after 5-7 days, the overall duration of “triple timing therapy” was less than that of other therapies, such as psychotherapy, antidepressants, exercise, or light therapy. Moreover, patients favored timing therapy. In terms of treatment effects, 3-7% of patients in the timing therapy group showed a response after 5-7 days, while in the control group, only 1.5% reported improvement.
However, this method is not suitable for all patients. Some doctors warn patients with depression and manic episodes undergoing sleep deprivation not to use this method lightly, as it may trigger a transition into a manic phase. Although, according to new research analysis, this occurs in only about 1 in 100 cases, it is still worth being cautious.
In specific treatment, sleep deprivation is typically carried out once a week in the ward until there is a noticeable improvement in the condition. Among a few peer patients, those affected also found it easier to stay awake. The method should not be used for self-management unless consulted with experts. It is also necessary to check for any risk factors and contraindications, such as a tendency for seizures before sleep deprivation. Overall, this chronic therapy seems effective and well-tolerated for patients with depression. Nevertheless, further clinical research by investigators is needed.
