Gann H, Riemann D, Hohagen F, Strauss L G, Dressing H, Müller W E, Berger M
Central Institute of Mental Health, Mannheim, Germany.
J Affect Disord. 1993 Jun;28(2):133-40. doi: 10.1016/0165-0327(93)90042-i.
We report a 64-year-old patient suffering from rapid cycling bipolar disorder who was studied by means of polysomnography, neuroendocrine tests and PET (positron emission tomography) imaging. In a manner only partly compatible with the cholinergic-aminergic imbalance model of mania and depression, a linkage of REM sleep disinhibition and depressive mood was observed, but no decisive REM sleep delay was seen on manic days. Growth hormone secretion after clonidine stimulation was blunted on depressive and hypomanic days. A series of total sleep deprivations led to a positive effect on psychopathology for about two weeks. Carbamazepine treatment normalized REM sleep variables, damped the amplitude of mood cycling of the patient, increased TSH and decreased FT4.
