Evidence map›Paper›PMID 30445386›Full record

Trial reportJournal of affective disorders2019

Early versus late wake therapy improves mood more in antepartum versus postpartum depression by differentially altering melatonin-sleep timing disturbances.

Barbara L Parry, Charles J Meliska, Ana M Lopez, Diane L Sorenson, L Fernando Martinez, Henry J Orff, Richard L Hauger, Daniel F Kripke

Open access · bronzeAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of affective disorders, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed
0.5field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 20 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Barbara L ParryDepartment of Psychiatry, University of California, 9500 Gilman Drive, La Jolla, San Diego, CA 92093-0804, United States. Electronic address: bparry@ucsd.edu.
Charles J MeliskaDepartment of Psychiatry, University of California, 9500 Gilman Drive, La Jolla, San Diego, CA 92093-0804, United States.
Ana M LopezDepartment of Psychiatry, University of California, 9500 Gilman Drive, La Jolla, San Diego, CA 92093-0804, United States.
Diane L SorensonDepartment of Psychiatry, University of California, 9500 Gilman Drive, La Jolla, San Diego, CA 92093-0804, United States.
L Fernando MartinezDepartment of Psychiatry, University of California, 9500 Gilman Drive, La Jolla, San Diego, CA 92093-0804, United States.
Henry J OrffDepartment of Psychiatry, University of California, 9500 Gilman Drive, La Jolla, San Diego, CA 92093-0804, United States; Department of Psychiatry, San Diego Veteran Affairs Healthcare System, United States.
Richard L HaugerDepartment of Psychiatry, University of California, 9500 Gilman Drive, La Jolla, San Diego, CA 92093-0804, United States; Department of Psychiatry, San Diego Veteran Affairs Healthcare System, United States.
Daniel F KripkeDepartment of Psychiatry, University of California, 9500 Gilman Drive, La Jolla, San Diego, CA 92093-0804, United States.
University of California San Diego · US

Funding

ZOVIRAX CREAM TO TREAT HERPES LABIALIS IN ADOLESCENTSM01RR000827 · NCRR · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI HAAS, RICHARD H · 1985 to 2010
$74.3M
Complementary Chronotherapeutics for Pregnancy and Postpartum DepressionR01HD076476 · NICHD · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI PARRY, BARBARA L · 2013 to 2017
$2.8M
Biological Rhythms in Postpartum DepressionR01MH070788 · NIMH · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI PARRY, BARBARA L · 2005 to 2009
$1.8M
Alternative Treatments for Premenstrual Dysphoric DisorderR01AT007169 · NCCIH · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI PARRY, BARBARA L · 2013 to 2017
$1.8M
Cognitive Behavioral Therapy for Insomnia for Veterans with History of TBIIK2RX001512 · VA · VA SAN DIEGO HEALTHCARE SYSTEM · PI ORFF, HENRY JOHN · 2016 to 2022
–
NCCIH NIH HHS R01 AT007169NCRR NIH HHS M01 RR000827NICHD NIH HHS R01 HD076476NIMH NIH HHS R01 MH070788RRD VA IK2 RX001512
6 · The paper itself

Abstract

backgroundPeripartum major depression (MD) disables mothers and impairs emotional and neurocognitive development of offspring. We tested the hypothesis that critically-timed wake therapy (WT) relieves peripartum MD by altering melatonin and sleep timing, differentially, in antepartum vs. postpartum depressed patients (DP).

methodsIn a university clinical research center, we initially randomized 50 women - 26 antepartum (17 healthy comparison-HC, 9 DP) and 24 postpartum (8 HC, 16 DP) - to a cross-over trial of one night of early-night wake therapy (EWT: sleep 3:00-7:00 am) vs. late-night wake therapy (LWT: sleep 9:00 pm-01:00 am). Ultimately, we obtained mood, overnight plasma melatonin and polysomnography for: 15 antepartum women receiving EWT, 18 receiving LWT; 15 postpartum women receiving EWT, 14 receiving LWT.

resultsEWT improved mood more in antepartum vs. postpartum DP in conjunction with reduced (normalized) melatonin-sleep phase-angle differences (PADs) due to delayed melatonin onsets and advanced sleep onsets, and increased (from baseline) total sleep times (TST). LWT improved mood more in postpartum vs. antepartum DP in conjunction with increased TST. LIMITATIONS: Small samples potentially rendered the study underpowered to detect group differences, making confirmation with larger samples essential. Sufficient follow-up data were not available in most women to document the duration of the mood response to wake therapy.

conclusionsEWT benefitted antepartum DP more by realigning melatonin and sleep timing, whereas LWT benefitted postpartum DP more by increasing TST. Thus, consistent with precision medicine aims, maximum mood benefits accrue from timing sleep/wake interventions to specific peripartum circadian pathophysiologies.

Indexed as

Time FactorsAdultAffectCircadian RhythmDepression, PostpartumFemaleHumansMajor Depressive DisorderMelatoninPolysomnographyPregnancyPregnancy ComplicationsSleepSleep Wake DisordersTreatment OutcomeWakefulnessMelatoninChronobiologyMelatoninPeripartum depressionPhase-angle differencesSleepWake therapy

Identifiers

PMID30445386
PMCPMC6351205
OpenAlexW2900331720

What OpenQuestion holds

Textmetadata
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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.