The treatment, which requires patients to stay awake for 36 hours, three times per week, is covered by Italy’s national health service.
A good night’s sleep is considered critical for mental, physical and emotional well-being, but a group of doctors in Italy is turning that knowledge on its head, by recommending sleep deprivation as a therapy for bipolar patients who are severely depressed.
“It’s absolutely counterintuitive,” Dr. Francesco Benedetti, head of psychiatry at San Raffaele Hospital in Milan, told the BBC.
In Benedetti’s unit, patients who have treatment-resistant depression turn to sleep deprivation in hopes of improving their mental health.
“They very often come to us and say ‘I’m helpless, nothing can be done.’ And that’s the perfect patient to try this most effective, rapid, shocking treatment to push up their mood,” Benedetti said.
The Treatment
The treatment, which requires patients to stay awake for 36 hours three times per week, is covered by Italy’s national health service.
Benedetti says that while sleep deprivation can contribute to depression for most people, it can alleviate symptoms for people with bipolar disorder. During the course of the treatment, patients are exposed to bright white light for about 30 minutes in the early-morning hours. That’s when most patients report a change in their mood, Benedetti said. After the treatment, patients are given Lithium, a common treatment for bipolar disorder, to keep their mood elevated.
Benedetti claims that the treatment works for 70% of patients.
“We see our patients being well after the treatment. They’re staying well. They return to their jobs,” he said. “They came in thinking of suicide, to be clear, and they go home ready to start their job again.”
The BBC followed four patients, who reported a change after the treatment.
“These nights, I was a little better. But this morning just awake, I felt that sensation of desperation,” said one patient, Georgio, a man in his sixties who has been battling depression for 20 years.
Georgio didn’t think the treatment had worked initially. In fact, he booked electroconvulsive therapy after the fact. But before he could try that, he found his depression was alleviated about a month after the treatment, and he believed that sleep deprivation may be why.
Another patient, Norma, said that she first went through sleep deprivation therapy four years ago and experienced an instant change to her bipolar symptoms.
“When I left here I felt fantastic,” she said. “I could tell straight away that I was better.”
Since then, Norma has had two depression flareups, and both times sleep deprivation therapy has helped, she says.
However, other mental health experts including John Geddes, head of psychiatry at Oxford University, are skeptical of the treatment and say a controlled study must be done.
“When people are developing treatments and are enthusiastic about it all sorts of biases come in,” Geddes said. “We just see this all the time, particularly in the area of mental health. There’s so much to gain from a study of a new treatment.”
