Can critically timed sleep deprivation be useful in pregnancy and postpartum depressions?

Background: The aim of this study was to test the efficacy of critically ti med sleep deprivation in major mood disorders (MMD) occurring during pregna ncy and postpartum. Methods: Nine women who met DSM-IV criteria for a MMD w ith onset during pregnancy or within I year postpartum underwent a trial of either early-night sleep deprivation (ESD), in which they were sleep depri ved in the early part of one night and slept from 03:00-07:00 h, or late-ni ght sleep deprivation (LSD), in which they were deprived of sleep in the la tter part of one night and slept from 21:00-01:00 h. Mood was assessed befo re the night of sleep deprivation, after the night of sleep deprivation, an d after a night of recovery sleep (sleep 22:30-06:30 h) by trained clinicia ns, blind to treatment condition, using standardized scales. Results: More patients responded to LSD (nine of 11 trials: 82%) compared with ESD (two o f six trials: 33%) and they responded more after a night of recovery sleep (nine of Il nights: 82%) than after a night of sleep deprivation (six of 11 nights: 55%). Pregnant women were the only responders to ESD and the only nonresponders to LSD. Limitations: The small and heterogeneous sample size prevents us from making more definitive conclusions based on statistical an alyses. Conclusions: Although the findings are preliminary, the results sug gest that with further study, critically timed sleep deprivation interventi ons may benefit women with pregnancy or postpartum major mood disorders and potentially provide a viable alternative treatment modality for those wome n who are not candidates for pharmacologic or psychotherapeutic interventio ns. Such interventions are needed to help prevent the devastating effects o f depression during pregnancy and the postpartum period on the mother, infa nt, her family and society. (C) 2000 Elsevier Science B.V. All rights reser ved.