Lack of sleep, as a rule, leads to serious problems: hypertension, blurred vision, and memory problems. The most common sleep disorders are insomnia, mental disorders, and being too busy.
Sleep deprivation is most common among teenagers and young adults, and for some of them, staying awake is a conscious choice. One day, 17-year-old Randy Gardner deliberately, and his result was included in the Guinness Book of Records. The record was later broken by Maureen Weston, who did not sleep for 18 days.
According to statistics on sleep deprivation on VKontakte, most often people between 16 and 25 years old deliberately do not sleep. The main reasons for conscious interruption of sleep among young people are the appearance of hallucinations and. In special groups on social networks, marathons are held, where participants do not sleep for several days (from 3 to 9 days) and, along the way, the effects of long-term deprivation.
States of altered consciousness that occur due to interrupted sleep are similar to drug intoxication. According to some studies, long-term sleep deprivation can cause addiction, which can subsequently lead to drug use. psychoactive substances.
15 years old, Omsk. Haven't slept for 10 days
I spend most of my time at home and am rarely allowed to go out. I live with my mother, my younger brother, who has a disability, and my semi-paralyzed grandmother, with whom I share a room. I haven’t seen my father for eight years and I don’t want to see him.
At the age of 12, I was forced to go to a psychologist, but this did not save me from nervous breakdowns and rejection of my appearance - I always had complexes about my figure. I used radical methods of losing weight - fasting and heavy physical exercise. Even at that moment I was depressed. All this resulted in (self-harm. - Note ed.). I hid the cuts, and then at school there was a check to make sure no one got drunk because of it, and my scars were noticed. The houses were screaming. They bought me some scar cream, and I started cutting my legs. In the end, I decided to try to change something on my own.
I learned about sleep deprivation from the Internet when I was looking for ways to treat depression. There I read about pleasant consequences in the form of hallucinations and expansion of consciousness. It seemed to me that this was a salvation from all problems.
I started practicing deprivation a year ago, during which time I have not slept for a long time more than ten times. On average, during deprivation I do not sleep for 4–6 days. I approached the first time thoroughly: I read a lot of all sorts of articles and reviews. It only lasted me four days: I felt like a loser because I had a lapse (from the phrase “falling asleep”) - this is when you accidentally fall asleep on long time. By the way, there is also microsleep - when you fall asleep on a short time and you don't realize it.
The worst glitch was at the end: when I looked in the mirror and saw that I had no face
My record is 240 hours. Then I set myself the goal of holding out as long as possible. On the first night I had in my head White noise. Already on the fourth day, glitches began: I saw a spider the size of a fist on the wall. From the fifth day a terrible headache appeared, and then heartburn due to hunger was added to this. I also had a pounding in my heart, probably due to high blood pressure.
I was constantly haunted by hallucinations: in my peripheral vision I constantly saw someone following me. The worst glitch happened at the end: when I looked in the mirror and saw that I had no face. IN last days it seemed to me that if I fell asleep, I would die. Tides of hyperactive vigor were replaced by simply hellish fatigue. My eyes hurt so much that it was difficult to open them. I felt an irresistible urge to lie down. So that no one would suspect anything, I used all my acting abilities and pretended that everything was fine. I attributed the loss of energy to fatigue after school, and to look cheerful I drank tonic drinks and used cosmetics.
After two days without sleep, the concept of time disappears and you dissolve in space
Long-term deprivation is similar to intoxication or a mild trip, although I have not tried drugs. I haven’t noticed any expansion of consciousness, but when I wake up after long-term deprivation, I feel like a different person. In the process, I feel like a researcher of my own body.
Sleep deprivation became an obsession for me. Giving up sleep doesn't solve my problems, but it does make me look at them easier. Now I’m taking breaks: I read that if you practice often, you’ll just get insomnia and the feeling will disappear high. I will definitely repeat it, because now I want to learn how to make my dreams lucid.
Konstantin (name changed at the request of the hero)
20 years old, Crimea peninsula. Didn't sleep for 4 days
For me, a dream is nothingness in miniature: wonderful, beautiful, but meaningless. I learned about sleep deprivation at the age of 15 from Wikipedia, and by the time I was 16 I had not slept for 48 hours straight. I decided to try sleep deprivation because I wanted to get glitches and change my thinking. Later this grew into a desire to test my own capabilities.
At the very beginning it was difficult to hold out even for two days. I drank energy drinks and coffee, but it didn’t invigorate me. Willpower and a to-do list for the night are the most important, because if you do nothing and look at pictures, you will fall asleep. The main thing is not to throw narcotic stimulants into yourself - this will not end well.
After two days without sleep, the concept of time disappears and you dissolve into space. The body floats, thoughts take on unexpected meaning, sounds become bright and rich. Hallucinations are different - as much as your imagination allows. For example, snakes can crawl under the carpet if you stare at it for a long time. What I remember most was my friend and I’s experiment: after three days without sleep, we sat down in front of the mirror and began to look into it. At first nothing happened, but then it became creepy: abstract images appeared, and in the end it seemed to me as if I was in some kind of alien space, where different images were rushing through me.
I have tried different sleep deprivation schedules. There were 48 hours of wakefulness versus 10 hours of sleep - and so on for weeks on repeat. Or total deprivation once a week. The parents never noticed anything - a classic case.
After a couple of years of total sleep deprivation, my interest in this decreased and I came to polyphasic sleep- sleep 3-4 hours day and night. I practiced it until recently, but I realized that combining it with my lifestyle is quite difficult. Now six hours of sleep is enough for me.
Experiments with sleep increased the body's endurance, the strength to do various activities appeared, and anxiety went away. But there are other, very unpleasant moments: due to the last sleep schedule, when I was awake for twenty hours and slept for four, I began to experience sleep paralysis. I remember this moment well: I woke up from a nightmare, sat on the corner of the bed for a couple of minutes, drank water, and decided to lie down for a while to move away. I closed my eyes and began to hear beautiful sounds, then bright images appeared and I saw myself flying through them and turning into music. But suddenly a rumble began to grow in the background, which gradually interrupted the images and music and turned into unbearable white noise, then into ultrasound. I felt like I was flying through a tunnel, objects were flying around me, and the sensation of physicality and consciousness became relative. I tried to break this chain, to scream, but my voice broke. I felt unbearable fear and woke up. I saw a flickering image of my room in a broken form, which after a few seconds assembled like a puzzle into a familiar picture. This is much more terrible than one can describe or imagine. This is exactly what drives you crazy. Having experienced such a shock, I thought about the impact of my experiments on health, but came to the conclusion that there were many more advantages. I don’t plan to return to deprivation or polyphasic sleep in the near future, but in the future I definitely will. The main thing is time. It's very nice to have, say, 30 hours free.
21 years old, St. Petersburg. Didn't sleep for 7 days
Now I’m trying to recover from sleep deprivation, I try to control myself, but sometimes I still break down. I took myself weakly and went too far. I started staying awake more than six months ago. On average, I didn’t sleep for 4 days, and once it turned out to be 7 - and this became a turning point.
After two or three days, complete emotionlessness sets in: no one bothers you, and, in fact, you don’t bother anyone either. They ask you something, but you just remain silent because you can’t and don’t want to answer. I didn’t see much point in telling someone about problems already in my school years: the whole class hated me, they gathered in a group and beat me. Why speak if no one will stand up for you anyway? And now there are no people who could support me.
Deprivation helps well if you need to deal with accumulated problems or depression. When you stop sleeping, day after day your senses become dull, emotions disappear, and it becomes easier to look at life and find the reasons for your disgusting state. There is a feeling that you can adjust your personality however you want.
Because of glitches and all the experiments on myself, I began to feel paranoid: maybe it was there before, but now I feel it more than ever
When I feel bad, total deprivation begins unconsciously. I deprive myself of sleep, food and water, and everything happens automatically. If you don't take care of this, you stop feeling your body. It feels as if it is dying - it puts a lot of pressure on the consciousness. There were moments when I wanted to kill myself. When you have already found the answers to the questions you asked yourself before deprivation, but you continue to obsess over something, it develops into madness. A consuming feeling of unfulfillment appears. You realize that the Universe is huge, but at the same time you understand that even in it there is no place for you.
The side effects of sleep deprivation for me were mental problems. Not everyone can endure prolonged hallucinations: images of people, the feeling that someone is watching you in the dark. Because of glitches and all the experiments on myself, I began to feel paranoid - maybe I had it before, but now I feel it more than ever.
On two occasions, when I didn't sleep for a long time, I had blackouts. I don’t remember anything that happened then - it was as if I had never lived. I tried not to pretend that something was wrong with me - everything was fine, I just couldn’t sleep.
Rustem Gaifulin
Administrator of the public about sleep deprivation on VKontakte, organizer of group deprivations
The group was created in 2011, when I just learned about the phenomenon of sleep deprivation. At that time I was tormented by insomnia; I could often go without sleep for two days. The community was primarily needed to bring together people with similar interests. The audience is mostly quite young - 16–25 years old.
Later, quite by accident, I came up with the idea of group sleep deprivation (participants stop sleeping at the same time and exchange impressions in the process. - Note ed.). Once upon a time I participated with everyone, but now I have almost no time. I am extremely approving of participants who extend the period of deprivation to 5–10 days. They still try.
Now the group is more like a family. New faces are good, especially if they are nice guys, but the larger the audience, the higher the degree of inadequacy.
Dorothy Berman
Psychiatrist, somnologist, psychotherapist at the Transfiguration clinic
Sleep deprivation is used as alternative method treatment of tolerant (insensitive to conventional therapy) depression and its varieties: apathy, melancholy. This treatment method is not recognized by all orthodox psychiatrists and psychotherapists and is not the choice of classical medicine.
The sensations of lack of sleep for 2-3 days are more reminiscent of alcohol or drug intoxication. There is a feeling of euphoria, hypomanic (optimistic-joyful. - Note ed.) mood, a state of some muted consciousness and disinhibition in behavior. With longer practices, hallucinations and disturbances in the perception of one’s body and surrounding space appear. These experiments will be most dangerous for people with chronic diseases. For example, if you are prone to glucose metabolism disorders, diabetes mellitus may develop due to the inability to absorb glucose during sleep. With metabolic problems, decreased production growth hormone(a growth hormone. - Note ed.) due to sleep deprivation leads to the replacement of muscle mass with fat, slower growth and uniform physical development. This is very important in adolescence and young adulthood, since the body’s growth continues until the age of 25–28. If there is a family history of mental illness, prolonged sleep deprivation is likely to lead to psychosis or neurotic disorder.
The issue of using sleep deprivation as prescribed by a doctor is hardly relevant for young people. They want to live brightly and richly, they need to look for themselves and explore the world in all its manifestations. If you prevent the passage of the stage of self-knowledge in personal development, the crisis period will not be passed, and this will come back to haunt you in adulthood with problems such as antagonism, self-doubt and lack of understanding of your place in life.
It is worth remembering that people with existing mental characteristics, family problems and psychological difficulties are prone to using psychoactive substances and experimenting with their bodies. It is important not to overlook the moment when a boy or girl really needs the support, knowledge and experience of adults. We can unobtrusively offer alternative ways getting adrenaline, knowledge about yourself and a feeling of being needed in this world.
Teenagers want to change the whole world, but at the same time they understand that this is impossible. Powerlessness gives rise to feelings of depression and apathy. And then, realizing the insignificance of their capabilities, they find their own way to cope with the situation - to escape from the real reality into a fantasy one that they create themselves. Perhaps one of the reasons for sleep deprivation is that they want nothing to do with it so much terrible world, they do not want to depend on him so much that they begin to deny even their own physiological needs in dreams, and often in food.
You can find information on the Internet that sleep deprivation can cure depression. For young people, this may look like a solution to their problems. However, depression is a complex mental disorder, and it should be diagnosed by specialists, and even more so, only they should prescribe treatment. The consequences of self-medication for depressive-like conditions can have unpredictable and catastrophic consequences, similar to misuse potent psychotropic drugs.
Behind psychological health children are answered by their parents. And it is they who should be the first to notice that something wrong is happening to their children, so that if necessary, they can turn to a psychologist. But it often happens that adults do not notice the changes taking place in a teenager, so he is left alone with his feelings of depression and despair. And the fact that no one sees this makes his condition even worse. Indeed, in most cases, teenage self-destructive behavior is an unconscious call for help and the hope that help will come.
Sleep deprivation is a technique of partial or complete deprivation of the ability to fall asleep in order to achieve a certain therapeutic effect. Most often, this method is used in the treatment of mental illnesses such as melancholy and depressive syndrome. The method under consideration allows us to solve problems caused by psychogenic and organic disorders in human consciousness. In order to understand the essence of this method, you should consider the methodology of the procedure and various nuances associated with its use.
Sleep deprivation is a lack of or complete absence satisfy the need for sleep
The founder of the method under consideration is the German psychotherapist W. Schulte, who in the late sixties of the last century presented to the public his own research on sleep deprivation. According to this outstanding scientist, the technique in question is one of the effective methods for solving the problem associated with prolonged depression. However, this technique has been known for many centuries, since it was this method that was used as punishment in ancient Rome for various crimes.
The state in which a person is found who deliberately refuses sleep for a long time can be compared to intoxication. It is important to pay attention to the fact that doctors talk about high risk appearance diabetes mellitus in persons practicing such techniques. This is explained by the fact that the body of a person who has refused sleep has a harder time assimilating glucose. That is why many experts do not recommend using this technique in the treatment of mild forms of depressive syndrome. Treatment of depression with sleep deprivation is used only in the following cases:
- High probability of relapse. Not always the use of potent medications against depression brings the desired effect. If there is a risk possible relapse, the physician may consider the relevance of this method. However, during this procedure it is very important that the patient is under constant supervision.
- Presence of suicidal tendencies. The development of depressive syndrome negatively affects the state of the nervous system. Many patients, contrary to common sense, begin to think about own death. Such thoughts can sooner or later lead to a suicide attempt, which can be avoided through deprivation treatment. However, it is recommended to use this method only if there is a serious threat to the patient's life.
- Inability to use drug therapy. There are situations when doctors are forced to refuse conservative methods treatment due to the characteristics of the patient’s body. These features include allergic reactions caused by the ingestion of drug components into the patient’s body. In this situation, the technique under consideration is an effective alternative, provided there are no contraindications to its use.
Often the announced procedure is used along with medications in the composition. complex treatment. The advisability of using sleep deprivation should be discussed only in cases where the patient is trying to harm his own health. Psychologists say that depression should be perceived as dangerous disease, which can negatively affect the patient’s mental state. Lack of timely treatment can lead to catastrophic consequences for the body.
Sleep deprivation is used to treat depression In what cases is the deprivation method used?
The deprivation technique is not recommended to be used independently, due to the possible negative impact on the human psyche. That is why the decision to use this technique should be made by a specialist based on the patient's condition. Sleep deprivation for depression is recommended for use to achieve the following goals:
- To replenish emotions and feelings. The development of depressive syndrome is often accompanied by a loss of personal feelings. In such a state, a person experiences apathy, which prevents him from realizing himself in various aspects of life. The technique of giving up sleep for a certain period of time allows you to increase self-esteem and bring positivity into your own life.
- Reduced irritability. In the case where a person does not have suicidal tendencies, depression does not pose a danger to human life. However, most people in this condition often show their temper and causeless aggression towards their loved ones. The use of this technique allows you to reduce irritability, which has a beneficial effect on personal development.
- Increased duration of remission. There is a certain category of people who are prone to depressive disorder. In order to reduce the risk of developing chronic depression, it is permissible to use a method of artificially refusing sleep. It is important to note that in the initial stages of therapy the patient’s well-being may worsen. That is why this technique used only as part of complex treatment.
- Eliminate feelings of confusion. Many people, falling into depression, say that their fate is controlled by evil fate and they simply do not have the strength to deal with the current difficulties. The feeling of confusion is part of the behavior pattern and negatively affects the patient’s personality. Carrying out complex treatment in combination with artificial refusal of sleep allows you to normalize the psycho-emotional balance, thereby setting the person up for positive thoughts.
- Troubleshooting memory problems. Memory lapses, a phenomenon characteristic of diseases such as alcoholism and malignant neoplasms, localized in the brain. However, with severe chronic depression, many patients face a similar problem. The use of therapy based on sleep refusal can partially or completely solve the problem.
- Reducing the risk of developing psychosis. Many people mistakenly assume that development depressive disorder accompanied by emotional lethargy, despondency and blues. However, there are forms of this disease in which the patient negatively perceives not only his own life, but also the world around him. It is very difficult to reduce the level of hatred, since the appearance of this feeling indicates the rapid development of a mental disorder.
In science, research and experiments on sleep deprivation are carried out on humans and animals. Due to depressive syndrome, many patients develop attention deficit. Being in a state of emotional depression, a person experiences urgent need in supporting family and friends. Lack of attention to one’s own person can cause the development of various inferiority complexes. The danger of this condition is explained by the high risk of developing paranoia. In the case of paranoia, it is important to understand that the patient needs inpatient treatment with potent medications. However, in combination with traditional methods, some clinics use the method of artificial sleep deprivation to relieve acute attack crazy thoughts.
It is important to pay attention to the fact that the above-mentioned consequences of prolonged depression can develop even in people with a balanced psyche, which is why you should promptly seek help. medical care, feeling the first signs of the impending blues.
When not to use sleep deprivation
The decision on the advisability of using the technology in question should be made exclusively by a specialist. It is not recommended to use this procedure if there is a need to travel long distances, as well as for people engaged in activities that require increased concentration. These measures are explained by the fact that human brain unable to concentrate with severe general fatigue. Therefore, in order to avoid possible complications for mental health, it is recommended to refrain from using such measures.
It is also prohibited to use artificial sleep refusal when taking medications with a sedative effect. The principle of action of these drugs is based on complete relaxation of the body in order to achieve peace. The procedure itself involves exposure to various irritants in order to combat drowsiness. This is why experts strongly advise against using sedatives during treatment.
Attention should also be paid to the fact that such potent methods, which can affect mental health, it is prohibited to use in the presence of mental disorders. Experts say that the state of violent insanity requires the use of potent drugs, so it is impossible to predict in advance the impact of the therapy method in question.
Sleep deprivation is not recommended during pregnancy and during breastfeeding, since the lack of proper rest can negatively affect both the baby’s development and the amount of milk produced. Such experiments with one’s own health can lead to the fact that the child will have to be forced to transfer to artificial feeding, thereby depriving him of the full amount of useful elements entering the body along with mother’s milk.
Sleep deprivation is used in the treatment of certain types of depression, especially with elements of apathy Various techniques for artificially giving up sleep
Let's move on to the question, what is sleep deprivation? Today in medical practice several various methods artificial refusal to sleep, which have their own characteristic differences. The selective method is an independent method of getting rid of drowsiness using special stimuli. Sleep is divided into several phases, from which the phase of rapid immersion should be distinguished. At this stage of night's rest, a person falls asleep, but brain activity continues to be fully active. The selective method is used in the presence of mild disorders that do not require the use of strict measures.
Partial sleep deprivation involves following a clearly structured pattern. The most commonly used scheme is in which the patient sleeps for five hours, after which he must remain active for the next 24 hours. After this, the procedure is repeated until the desired effect is achieved. The total form of sleep deprivation involves being in an active mode for several days. It is important to note that you should not get carried away with such methods, as there is a high risk of developing possible complications. Frequent use of a total form of artificial sleep refusal can lead to depressive disorder becoming chronic.
Nuances associated with the procedure
Before deciding on such treatment methods, you should carefully read the rules for its implementation. There are a certain number of restrictions that must be adhered to. First, let's look at how a sleep deprivation EEG is performed. The use of electroencephalography is necessary in order to observe brain activity both during nervous excitement, and at rest.
Application of this method diagnostic examination allows us to identify certain consequences of artificial sleep deprivation. You can combat the feeling of drowsiness during the procedure using various irritants. Bright lights and loud sounds will help reduce the desire to fall asleep and increase physical activity.
It is also important to say that such measures should only be used with the parallel use of antidepressants. The effect of these drugs should normalize the patient's condition and increase the level of physical activity. The most commonly used drugs are Venlafaxine and Fluoxetine, due to their mild effect on the body.
Sleep deprivation in depression is considered the most effective method treatment at present, it is compared with electroconvulsive therapy, which removes depression in a few hours.
It allows you to short term bring the patient out of deep sleep and restore normal sleep.
ABOUT therapeutic effect Everyone knows about the effects of starvation on the body. By depriving ourselves of food, we can pursue different goals, but the main one is health improvement.
Sleep deprivation (deprivation), voluntary or forced, exposes the body to severe pathological stress.
Constant lack of sleep. Causes, consequences: brain atrophy, early old age, osteoporosis, dementia, diabetes, obesity, etc.
Until 1966, it was believed that insomnia had only detrimental effects. That is why it has been used since time immemorial as the most sophisticated torture.
Thanks to Walter Schulte, a Swiss psychiatrist, they discovered medicinal properties insomnia. The researcher introduced sleep deprivation into medical practice, How effective method treatment sleep disorders for depressive conditions.
At first glance, this method looks paradoxical: a person is exhausted by insomnia, but he is not allowed to sleep at all! However, there is a logic to this treatment.
The patient experiences a lack of full-fledged paradoxical sleep; deprivation of even that small proportion that is observed in him invariably causes stress, and therefore increased production of catecholamines (mediators and adapters of the most important physiological processes) that maintain emotional tone.
Increased tone stimulates the overall mental mood.
The result of treatment Even euphoria, which takes the place of a depressed state, can become sleep deprivation.
By the way, even the ancient Romans used prolonged wakefulness (2–3 days) to get rid of melancholy (the word depression was unfamiliar to them).
Studies have shown that the biochemical mechanisms of therapeutic sleep deprivation and therapeutic fasting are similar and are caused by a decrease in the concentration of carbon dioxide in the patient’s blood.
How does the sleep deprivation method work?
Periodically occurring processes healthy person strictly coordinated and subject to a 24-hour daily rhythm. This applies to sleep patterns, changes in body temperature, appetite, heart rate, metabolism and blood pressure.
In a depressed patient, many of these processes are disturbed:
The structure of sleep is mismatched,
In women it is disrupted menstrual cycle,
The mental state becomes characteristic: in the morning there is a decrease in appetite, a melancholy mood, lethargy, and in the evening these manifestations decrease.
Thus, one of the main factors of depression is mismatch and desynchronization of cyclic physiological and biochemical processes in the body. Deprivation is an attempt to restore the balance between them by changing the order of biological rhythms.
Sleep deprivation is used most often in the treatment of endogenous depression accompanied by elements of apathy:
- decrease in emotional level,
- mental retardation,
- obsessive ideas of futility, guilt,
- self-criticism etc.
The effect of sleep deprivation on various depressive conditions:
Manic-depressive psychosis responds best to treatment, improvement occurs in 74%,
In schizophrenia – in 49.3%,
With neurotic depression – in 32.6%.
Those with melancholy depression recover the fastest, while those with anxious depression recover slower; masked depression is almost untreatable.
The severity of the disease and the effectiveness of deprivation are directly proportional: the more severe the disease, the more effective the treatment.
Elderly patients are less responsive to deprivation treatment.
Sources: A.M. Wayne “Three Thirds of Life”, A. Borbeli “The Mystery of Sleep”, methodological recommendations of the 1980 Ministry of Health of the RSFSR “Sleep deprivation as a method of treating patients with depressive conditions”.
Elena Valve for the project Sleepy Cantata.
Sleep deprivation for the purpose of treating depression first began to be practiced in one of the Swiss clinics back in the 70s of the last century. IN this state a person is deprived of sleep intentionally or forcibly. From historical sources it is known that this practice was used in Ancient Rome. Its inhabitants deprived themselves of night rest in order to increase productivity.
Practice in human history
Sleep deprivation is, simply put, deprivation of rest at night. This method is almost the only one that can bring a person out of a severe melancholic state in a matter of hours. This practice usually takes place in psychiatric institutions.
In ancient Rome they knew that a sleepless night spent having fun could relieve a person from the symptoms of mental anguish for a short time. For many centuries, this practice was undeservedly forgotten. It was rediscovered in 1970 in a psychiatric hospital in Switzerland. After this, interest in it increased, but gradually priority returned to other methods of treating depression - in particular, medication.
The meaning of the method
Sleep deprivation treatment is carried out in psychiatric hospitals, since the use of this method is unpredictable and must be supervised by a specialist. The essence of the method is this: a person simply skips one night. He wakes up, for example, on Monday morning and decides that today he will engage in this practice. His day goes by as usual. Then follows a sleepless night, and after that another day of wakefulness. He goes to bed on Tuesday evening and rests for about 10 hours. The deprivation cycle is therefore 36 hours.
Types of procedure
Three main types of sleep deprivation are used for targeted treatment of depressive conditions. Each of them has certain characteristics.
- Total. It consists in the fact that a person is awake for 36-40 hours. You should get a good night's sleep the night before the procedure. Then the person does not sleep during the day, night and subsequent day. This technique is quite complicated. It entails unpredictable consequences. For achievement positive results in the treatment of depressed patients with this method, in the first week the experiment is carried out twice. Then deprivation is carried out once a week for 4-6 weeks.
- Partial deprivation. The technique is based on reducing the amount of sleep to critical level. Rest lasts no more than 4 hours a day. Gradually the body gets used to this state. For some, the feeling of weakness disappears already on the 4th day. For other patients, it takes several weeks to achieve the desired result.
- Deprivation of the REM stage of sleep. This stage is otherwise called paradoxical sleep. During this, there is high brain activity. The meaning of derivation at this stage is sleep deprivation at this particular time. As soon as the devices signal the onset of the REM stage, the patient is woken up. Then he falls asleep again. Such short-term awakenings continue throughout the night. The effectiveness of this technique is higher than the previous two. However, it is more difficult to carry out, since it requires special equipment and the presence of somnologists.
How to carry out the procedure?
At this time, patients are advised to occupy themselves with an interesting activity that requires mental activity. Physical activity should be minimal. Boring activities should be avoided (watching TV or reading a long classic novel can act as a sleep aid). It is useful to draw up a lesson plan in advance, sketch out a list of interesting things to do.
For the experiment to be successful, patients are also advised to follow the following rules:
- Do something interesting. If during the entire procedure you think about how not to fall asleep, this will most likely happen. Taking up a fun hobby will help increase dopamine production, which will ease deprivation.
- Change your assessment of the situation. To overcome the natural physical need, it is recommended to consider the procedure not as sleep deprivation, but as wakefulness.
- Postpone responsible work and important decisions. Deprivation distorts the perception of reality. Best option- perform the work to which the brain is already accustomed.
- Limit traffic on the street. The brain may not perceive moving vehicles, and there is a high risk of blackout in the middle of the road. On the day after a sleepless night, it is recommended not to leave the house at all.
- Do not overuse coffee. This drink can help you get through the night. But it disrupts the functioning of the central nervous system, which reduces the effect of the procedure and also puts a strain on the cardiovascular system.
Features of sleep deprivation in depression
In patients with melancholia this type therapy allows you to achieve the following results:
- Partial remission. The patient is not immune from repeated episodes of depression even when taking potent medications. In the event of a reported relapse, this practice can be extremely useful. Of course, it is carried out only according to a doctor’s indication.
- Reducing the risk of suicide. The nervous system of a person who is constantly depressed is subject to serious stress. Obsessive thoughts about dying can take over your mind, increasing the risk of suicide. Sleep deprivation for depression significantly reduces this life-threatening syndrome.
- Inability to take medications. If the patient, in addition to depression, suffers from allergies, and is prohibited from taking antipsychotics and antidepressants, deprivation of night rest becomes the most optimal option.
- Additional method therapy. The procedure is often prescribed in combination with drug treatment. It is most appropriate for long-term depression.
Psychiatrists recommend not to perceive a reduced emotional background as a trifle, not worth attention. After all, the consequences of depression can be irreversible. Therefore, you should consult a specialist regarding possible application sleep deprivation as a method of getting rid of melancholic symptoms.
Side effects during the experiment
Already in the morning after the first session, the symptoms of depression go away, the person feels much better in psychologically. But when he goes to bed and wakes up the next morning after the 40-hour experiment and subsequent sleep, the symptoms of depression return with greater force. The only means of combating a reduced emotional background is repeated prolonged wakefulness. According to reviews of sleep deprivation, the most painful experience is repeated experimentation.
Basic side effects- drowsiness, high irritability. People who suffer from increased aggressiveness experience the effects of this quality even more. Peak sleepiness usually occurs around midnight and before sunrise (5-6 am).
The consequences of sleep deprivation are not the most pleasant. Patients note that during sleep deprivation, performance is seriously reduced. Fatigue sets in quickly. Fatigue is very difficult to fight.
According to research, chronic lack of sleep leads to irreversible changes in the brain. Partial sleep deprivation is not recommended to be abused.
Benefits and harms
This procedure is considered useful the following reasons:
- Allows you to eliminate symptoms of depression without the use of medications.
- Allows you to significantly improve the quality of sleep.
- Increases the speed of work completion.
- Helps quickly recall information from short-term memory.
Neurologists view sleep deprivation as a necessary procedure to cope with various mental disorders, anxiety, aggressiveness. In their opinion, it is quite sufficient to use partial deprivation, shortening night sleep up to 4-5 hours. But for depression, sleep deprivation will be most effective if it lasts 36-40 hours.
But deprivation of night rest for therapeutic purposes also has many opponents. After all, lack of sleep, according to scientists, leads to the accumulation of large amounts of toxins in the body. It provokes Alzheimer's and Parkinson's diseases. Sleep deprivation can also be a cause of heart problems. gastrointestinal tract, oncology, premature aging. Sleep deprivation also impairs the body's immune system.
Cognitive impairment due to sleep deprivation
Complete sleep deprivation leads to an increase in the speed of declarative-methodical memory. In other words, if a patient is asked to do some work that he already knows how to do, then the speed and attention when doing it will be at their best.
But many who have tried this method of therapy note that creativity suffers with prolonged sleep deprivation. A person in this state may believe that he is having brilliant thoughts. But in reality it will only be a figment of the imagination. A day after deprivation, changes in consciousness are observed that resemble symptoms of schizophrenia or alcohol intoxication.
When deprivation lasts more than 48 hours, the person's condition is similar to drug intoxication. The following symptoms are observed:
- Altered perception of reality.
- Loss of sense of time.
- Various types of hallucinations.
- Derealization.
- High fatigue.
Changes in the emotional sphere
One of the most important consequences of sleep deprivation concerns the effect of the procedure on the emotional background. When wakefulness continues for more than 48 hours, a person's nervous excitability, he becomes very suggestible. His ability to critically assess the environment, regulate his emotions, and distinguish the unimportant from the important decreases. A completely neutral event causes an increased emotional reaction.
Illusions and visions: another side effect
Another unpleasant consequence sleep deprivation - hallucinations. Of course, they do not occur in all cases, but it is impossible to predict the occurrence of this phenomenon.
Deprivation of night rest for more than five days is rightly considered dangerous for the state of the psyche. Some people who have not slept for several days have not only noticed the occurrence of auditory and visual illusions. The hallucinations did not disappear even after a full sleep.
Science does not have an exact explanation for this phenomenon. However, the most generally accepted version is the following: the senses begin to malfunction due to prolonged lack of night rest. In other words, a person sees something, but the brain does not receive information to process the data. The effect is similar to what occurs when a person is immersed in a special bath, in which no auditory, visual, or tactile information is received. If there are no external signals, the brain begins to produce missing information himself, creating his own images.
Auditory illusions arise after two days of deprivation. If the procedure lasts more than 2 hours, visual hallucinations. Everything that happens seems unreal to a person. He loses his sense of time. A stream of thoughts rushes through his head, which would normally take him a whole day to think through. Depending on the psycho-emotional state, hallucinations can be either friendly or hostile.
How is an EEG performed with sleep deprivation?
The electroencephalography method is one of the most popular types of diagnostics. Thanks to this method it is possible to determine fluctuations in the state of cells in different parts of the brain. The use of modern devices makes it possible to obtain information about the state of various parts of the brain in a short period of time.
The EEG diagnostic result is displayed as a curved line that appears as the recording progresses electrical activity brain
EEG with sleep deprivation is one of the most informative methods of examining the brain. Shown this procedure for sleep disorders, epilepsy, disorders hormonal sphere, psychosis, panic attacks. Patients with cerebrovascular accidents are often referred for this examination. How is an EEG performed on an adult with sleep deprivation? During the procedure, a cap with electrodes is placed on the head, which are attached to the equipment on the other side. Electrodes allow you to record electrical impulses in nerve cells, displaying them on a monitor screen. During the procedure, the patient sits in a chair or lies down.
Patient preparation
Electroencephalography with sleep deprivation is performed in following conditions:
- With bright lights on and off.
- With a loud sound.
- When breathing deeply.
- While falling asleep after sleep deprivation.
How to prepare for an EEG with sleep deprivation? The main point is compliance with all doctor’s instructions. It is important to continue taking medical supplies, appointed by a specialist. 12 hours before the procedure, you must avoid energy drinks, coffee and other stimulants. Before the procedure, you must wash your hair without using masks, balms or oils - otherwise the contact of the electrodes with the skin will be weaker. The patient should be calm and not nervous during the procedure.
Many sleep manipulation techniques have antidepressant effects, although they are not widely used in clinical practice. These include selective deprivation of REM sleep, partial and total sleep deprivation (partial - starts at one in the morning and continues until the next evening, total - starts in the morning of the first and ends in the evening of the second day, the duration of deprivation is about 40 hours), sleep phase shift by an earlier time relative to the time of day. Let us consider in more detail such a method of treating depression as sleep deprivation (SD), which, like electroconvulsive therapy (ECT), is currently considered a non-pharmacological method of treating depression, giving the most rapid antidepressant effect.
Interest in the clinical significance of DS, or wakefulness therapy, is due to the close relationship between sleep disorders, affective disorders and disturbances of biological rhythms. The first clear indications of the effectiveness of DS for depression were given by the German psychiatrist J. Heinroth. According to him, sleep deprivation is a remedy that seems cruel, but still has beneficial effects. Scientific research, dedicated to DS, received their active development after W. Schulte’s publications about casuistic cases of the antidepressant effect of DS, such as the case of a teacher who once “freed himself” from his depression by riding a bicycle all night. The first thorough studies of the therapeutic effectiveness of DS for depression were conducted by B. Pflug, R. Tölle (1971) at the Tübingen University Hospital (Germany). According to these studies, DS was more effective in the case of endogenous depression compared with neurotic depression, emphasizing that a combination of antidepressants and DS is likely to be the most appropriate approach for the treatment of depressive disorders. Subsequent work has shown that DS is a fairly effective method for treating depressive disorders. However, it has its own bottlenecks: after a night of “restorative sleep,” depressive symptoms almost always inevitably return, although the simultaneous use of DS and antidepressants helped reduce the rate of recurrence of depressive symptoms from 83 to 59% (Leibenluft E., Moul D.E., Schwartz P.J. , Madden P.A., Wehr T.A.; 1993.).
To date, the main hypotheses about the possible mechanisms of action of DS can be presented as follows:
■ modulation of the unbalanced functioning of the main neurotransmitter systems of the brain (neurotransmitter model);
■ impact on biological rhythms (chronobiological model): sleep deprivation can have an antidepressant effect due to resynchronization of disturbed circadian rhythms, normalization of the ratio of REM and non-REM sleep phases;
■ regulation of neurohormone metabolism (neurohormonal model): dysfunction of the hypothalamic-pituitary-thyroid-adrenal axis that occurs in cases of depression can be temporarily corrected by sleep deprivation;
■ impact on perfusion and metabolic processes of the brain, especially in areas of the limbic system - neurometabolic model;
■ other hypotheses: it is assumed that the antidepressant response to total DS (TDS) follows from the process of disinhibition (desinhibition) caused by increased fatigue during TDS;
■ possible significant influence of DS on the activity of the immune system;
■ the multifactorial model assumes a complex neurobiological impact of DS;
■ according to some hypotheses, DS is probably able to reduce the concentration of a hypothetical depressogenic substance that accumulates during sleep, or, conversely, increase the content of a hypothetical antidepressant substance during wakefulness.
The range of indications for the use of DS in psychiatric practice seems quite large. The most “broad” approach in this regard is the opinion of H. Giedke et al. (2002), according to which DS is a nonspecific therapy, and the main indication for DS is depressive syndrome. Modern research allows us to speak about the high efficiency of DS in unipolar and bipolar depression(Riemann D., Voderholzer U., Berger M.; 2002), including in the case of treatment-resistant depression. At the same time, some researchers (Barbini B., Colombo C., Benedetti F. et al.; 1998) emphasize that TDS has a more pronounced antidepressant effect in the case of depressive episodes precisely within the framework of bipolar affective disorder(BAD) types I and II, as well as in the case of a single depressive episode, but not recurrent depression. According to B.L. Parry et al. (2000), DS may be useful in cases of major depression in pregnant women and postpartum period as an alternative treatment method. Although the effectiveness of DS in these cases has not yet been well confirmed. DS can be effective for cyclothymia (Nosachev G.N., 1985), as well as for depression in schizophrenia (Kuhs H., Tölle R.; 1991). Summarizing theoretical and practical considerations regarding the use of DS, M. Berger and J. Sasse (2000) consider the use of DS justified in the following cases:
■ the need to take measures that complement other antidepressant therapy;
■ optimization of treatment in case of therapeutic resistance;
■ in patients who have achieved only partial remission while using antidepressants;
■ use as a “bridge” for the period of latent action of antidepressants and thus reducing the risk of suicide;
■ an auxiliary differential diagnostic tool for distinguishing between pseudodementia and incipient dementia (in the latter case, improvement in condition after DS is unlikely);
■ prediction of effect during subsequent antidepressant treatment;
■ study of the pathogenetic mechanisms of depression;
■ the need to prefer non-pharmacological treatment methods.
According to a number of researchers, the speed of onset of the antidepressant effect of DS justifies the widespread clinical use of this technique, despite the still not entirely clear basic mechanisms underlying the antidepressant effect of DS (Baghai T.C., Moller H.J., Rupprecht R.; 2006). The degree of clinical changes during DS in the case of depressive disorders covers a continuum from complete remission to deterioration (2 - 7%). A meta-analysis of 1,700 documented and published cases of DS in depressed patients shows that, depending on the diagnosis, in 60–70% of cases, patients respond with a clear improvement in mood after one sleepless night. The therapeutic effect of DS is detected already during the night, when the patient is awake, or the next day. About 10 - 15% of patients respond to therapy only after sleep recovery. Improvement in well-being can last for a week (Giedke H., Schwarzler F.; 2002).
When performing DS, side effects are very rare and insignificant (Wirz-Justice A., Benedetti F. et al., 2013.). The most frequently discussed issue in the literature is concern about the possible reversal of the depressive phase after SD, especially in the case of bipolar depression. However, increasing clinical evidence suggests that DS is no more likely to cause hypomanic/manic states than standard antidepressants. In the case of using DS for bipolar depression, the use of mood stabilizers is recommended (Colombo C., Lucca A., Benedetti F. et al. 2000).
As mentioned earlier, the overall improvement in depressive symptoms after DS is considered unstable by many experts, and ultra-short stages of sleepiness, especially napping in the early morning hours, may be responsible for this. In this regard, DS is usually combined with other pharmacological and non-pharmacological methods of treating AR. In general, the possibilities of consolidating the DS effect can be divided into several main areas:
■ the use of antidepressants and mood stabilizers: this approach enhances the effectiveness of antidepressant monotherapy, accelerates the onset of action of antidepressants, and is also an effective strategy for the treatment of treatment-resistant depression (WirzJustice A., Benedetti F., Terman M; 2013); the combination of DS with normotimic therapy is especially important in the case of bipolar depression (Colombo C., Lucca A., Benedetti F. et al. 2000);
■ use of shifting of sleep time: this is one of the main methods included in the arsenal of chronotherapy; Since afternoon naps and sleep in the first hours of the night have a less strong depressogenic effect, a possible way to avoid the return of depressive symptoms after DS is reported through a combination of DS and subsequent transfer of sleep time to a later date. early date(sleep phase advance); in this case, the time spent in bed falls on the period from 17.00 to 24.00 hours, followed by moving this sleep time one hour later every day for a week to the usual sleep mode (23.00 - 06.00 hours); this method allows patients to more comfortably endure the period after DS and therapeutically utilize their daytime drowsiness; however, as a rule, the parallel use of drug antidepressant treatment is not excluded (Psychiatrie und Psychotherapy / Hrsg. M. Berger, R.D. Stieglitz. - Jena: Urban & Fischer, 2000); the sleep phase shift technique can also be built according to a shorter, for example, three-day scheme (Wirz-Justice A., Benedetti F., Terman M.; 2013); It must be emphasized that organizing sleep phase shifts in routine clinical practice can be quite difficult due to the discrepancy between the sleep-wake schedule used in the respective patients and the general clinical daily routine4; therefore, this technique is most often used in outpatient settings;
■ morning light therapy after DS can prevent the return of depressive symptoms after compensatory night sleep in DS responders (Wirz-Justice A., Benedetti F., Terman M.; 2013);
■ use of ECT and other methods: there is evidence of the positive effect of combining DS with ECT or morning transcranial magnetic stimulation (Eichhammer P. et al., 2002).
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