EEG sleep in depression and in remission and the REM sleep response to the cholinergic agonist RS 86.

A comparison of the sleep EEG patterns of patients with a major depressive disorder intraindividually between remitted and depressed state revealed an improvement of parameters of sleep continuity and a tendency for normalization of rapid eye movement (REM) latency and REM density in the former. Additional application of the cholinergic agonist RS 86 prior to sleep did not reveal a heightened sensitivity of the REM sleep system in the remitted sample. Whereas a group of presently ill depressives displayed a drastic reduction of REM latency, results of the remitted patients were comparable to healthy controls. Furthermore, RS 86 significantly reduced slow-wave sleep in all groups investigated and had a differential impact on the density of the first REM period and early morning awakening in actively ill patients as compared to remitted patients. The results do not favor the hypothesis of a trait specificity of REM sleep abnormalities for depressive disorders. Furthermore they support the model of a cholinergic supersensitivity, as measured by REM induction after RS 86, as a state but not a trait marker of affective illness. Generalization of the present study may, however, be limited by the fact that the remitted patients were free of symptomatology and psychoactive medication for a long period (mean 3 years), therefore constituting an untypical group of formerly depressed patients with a seemingly low risk of relapse.