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GABAergic modulation during PSD, effects on microsleep and NonREM-sleep in volunteers and patients with major depression
The antidepressant efficacy of sleep deprivation (SD) in depressed patients can be prevented by early morning naps and microsleep (MS) during SD. The GABA-Benzodiazepine receptor antagonist flumazenil augments vigilance and reduces NonREM-sleep pressure and NonREM sleep associated growth hormone secretion in early morning recovery sleep.
Therefore, 27 patients with major depression were subjected to a partial sleep deprivation (PSD). In a double blind randomized design either flumazenil or placebo was orally applied during PSD. EEG was registered continuously for 60 hours by a portable device.
Flumazenil significantly suppressed MS during SD and increased slow wave sleep in the recovery night. Antidepressant efficacy of PSD was not different between flumazenil and placebo during PSD, but better after the recovery night in patients treated with flumazenil.
It is concluded that GABAergic mechanisms are involved in the regulation of MS and NonREM-sleep during PSD and may be associated with the antidepressant efficacy of PSD.