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Updated: Sep 10, 2025

Author Spotlight: Unveiling the Connection Between Sleep Disorders and Cognitive Symptoms in Depression
Published on: April 26, 2024
Slow wave activity during non-rapid eye movement (NREM) sleep in patients with major depressive disorder: a
Pauline Henckaerts1, Kristoffer D Fehér1, Elisabeth Hertenstein1
1Department of Psychiatry, Faculty of Medicine, University of Geneva, Switzerland.
Abstract:
Slow-wave activity (SWA) during non-rapid eye movement (NREM) sleep is the primary marker of sleep homeostasis and proposed to reflect synaptic strength. SWA might be reduced in patients with major depressive disorder (MDD), potentially reflecting reduced synaptic strength (synaptic plasticity hypothesis of MDD). In view of inconsistent findings in the previous literature, the aim of this meta-analysis was to test the hypothesis of reduced SWA in patients with MDD compared to healthy controls. PubMed, CINAHL and PsychInfo were searched for original publications comparing SWA during NREM sleep in adult patients with MDD to healthy controls. A random-effects model for meta-analyses was calculated using Hedges' g. The study was pre-registered in the international prospective register of systematic reviews (PROSPERO CRD42024537138). Five studies comprising 229 participants were included. The meta-analysis demonstrated a significant reduction of SWA during NREM sleep in patients with MDD compared to healthy controls (p = 0.0003, g = -0.5, medium effect-size, confidence interval -0.8 to -0.2) with low heterogeneity (Q-test; p = 0.518, I2 = 0 %). This meta-analysis demonstrates a significant reduction of SWA during NREM sleep in patients with MDD compared to healthy controls, consistent with the concept of reduced synaptic strength in patients with MDD.
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