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48-Hour Sleep-Wake Cycles in Manic-Depressive IllnessNaturalistic Observations and Sleep Deprivation Experiments
Thomas A. Wehr, MD;
Frederick K. Goodwin, MD;
Anna Wirz-Justice, PhD;
Jorg Breitmaier;
Carolyn Craig
Arch Gen Psychiatry. 1982;39(5):559-565.
Abstract
• Wrist motor activity and sleep were monitored longitudinally in 15 rapidly cycling and 52 nonrapidly cycling manicdepressive patients. The majority of patients experienced one or more consecutive 48-hour sleep-wake cycles (alternate nights with no sleep) when they switched out of depression into mania or hypomania. During a depressive phase, nine rapidly cycling patients were asked to simulate a 48-hour sleep-wake cycle by remaining awake for 40 hours (one night's total sleep deprivation). Eight switched out of depression, and seven were rated as manic or hypomanic; indicating that sleep loss (such as occurs with spontaneous 48-hour sleep-wake cycles) may help to trigger switches from depression to mania. The 48-hour sleepwake cycles in patients may depend on a mechanism that is normally present in all humans, since normal persons also spontaneously experience near-48-hour sleep-wake cycles in certain experimental conditions.
Author Affiliations
From the Clinical Psychobiology Branch, National Institute of Mental Health, Bethesda, Md.
Footnotes
Accepted for publication Dec 11, 1981.
Reprint requests to Clinical Psychobiology Branch, National Institute of Mental Health, Room 4S239, Bldg 10, 9000 Rockville Pike, Bethesda, MD 20205 (Dr Wehr).
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