Sleep, Wake and Light Therapy for Depression
Condition: Depression; Depressive Disorder, Major; Depression, Unipolar; Depression Moderate
MeSH terms: Depression; Depressive Disorder; Depressive Disorder, Major
Study type: Interventional

Summary: 
      The aim of this study is to determine if altering the pattern of one's sleep and having light
      therapy can speed up the treatment of depression. In the UK, the large majority of patients
      with depression in the NHS are treated in the community, and one of the major objectives of
      the study one is to determine if this therapy is a practical treatment in the community. We
      will be comparing two treatments:

        1. Sleep Therapy and a Light Box: Participants will be given information and advice on how
           to get a good night's sleep. Participants will be given a light box to use in the
           morning for 1 week. Treatment with a light box will last 30 minutes when a person gets
           up. Participants may continue to have any treatment as usual (for example medication or
           talking therapies).

        2. Wake therapy and a Light Box: Participants will be helped to change the pattern of sleep
           by depriving participants of sleep for one night. Participants will go bed at 5pm on the
           following day for 8 hours and get up at 1am. Participants' sleep will then be advanced
           by 2 hours each night for the next three nights. Participants will be also given a light
           box to use in the morning for 1 week. Treatment with a light box will last 30 minutes
           when participants get up. Participants may continue to have any treatment as usual (for
           example medication or talking therapies).
    

Detailed description: 
      -  Participants will be given a wristband (Actigraph)

        -  Participants will be asked to complete various questionnaires and be interviewed at 1
           week, 2 weeks, 4 weeks, 8 weeks and at 6 months after starting.

        -  Participants will be asked to make 6 extra visits to the research team at the hospital
           over and above those needed for normal care.
    

Intervention name(s): Wake and Light Therapy; Sleep and Light Therapy
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Participants will be helped to change the pattern sleep by depriving participants of sleep for one night. On Day 1 participants will be supported to stay up all night and the following day at the Hospital. Participants can go to bed by 5pm at home on Day 2. Participants will need to get up by about 1am and return to the hospital to be supported to stay awake. Participants will then go to bed at 7pm on Day 3. Participants will be asked to sleep until 3am and then stay awake at home until bed at 9pm on Day 4. Participants will then get up by 5am on Day 5 and stay awake until 11pm to resume a normal sleep routine waking by 7am on Day 6. Participants will also be given a light box to use each morning. For the light box, participants will be asked to sit about one foot away from a light box. You will be free to have breakfast, read or use a computer while facing towards the light. Treatment with a light box will last 30 minutes. Participants may continue to have treatment as usual.; Participants will be given information and advice on how to get a good night's sleep. Participants will be also given a light box to use in the morning for 1 week. For the light box, participants will be asked to sit about one foot away from a light box. Participants will be free to have breakfast, read or use a computer while facing towards the light. Treatment with a light box will last 30 minutes when you get up. Participants may continue to have any treatment as usual (for example medication or talking therapies).
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Both groups will receive treatment as usual.
Triple Chronotherapy. This consists of (a) Total Sleep Deprivation with group support on days one and two; (b) Phase Advance of Sleep over 5 days and daily Light Therapy. (c) Bright Light Therapy is given on Day 2 onwards daily.
Comparator Intervention: Participants will be given information on sleep hygiene and getting a good night's sleep in a written leaflet and given the opportunity to ask questions. They are then given Dim Amber Light Therapy daily for 1 week.
Masking: Single (Outcomes Assessor)
Primary purpose: Treatment
Keywords: Circadian Rhythm; Light Therapy; Wake Therapy; Sleep Phase Advance; Major Depression