Hector Warnes: Historical Overview of Sleep Medicine
5.Seasonal Affective Disorder


            Rosenthal identifiedthis disorder as related to the Winter and Fall seasons varying in prevalence from 1.5 to 9 % depending on the latitude of the country(Rosenthal et al. 1984).  Particularly, this recurring seasonal affective pattern appears when daylight hardly appears for more than a few hours and artificial light is required.  It occurs more often in women who are likely to experience hypersomnia, increased appetite, craving for carbohydrates, fatigue and depressed mood. 

            Seasonal Affective Disorder may co-exist with a Bipolar Disorder II. It should be distinguished from Atypical Depression and from rapid cycling affective disorders. Hypersensitivity to cholinergic stimulation, shortened REM latency and increase of REM pressure was found in Major Depression and Posttraumatic Stress Disorder but not in Seasonal Affective and Panic disorders (Baglioni et al. 2016)

            Terman, in a collaborative research project involving14 centers, studied 332 patients with Seasonal Affective Disorder (Terman et al. 1989).  He reported that the remission rate was62% when light therapy was administered at 2,500 lux intensity exposure early in the morning for a period of at least twohours formore than a week. It is possible that the therapeutic action of light therapy is mediated by serotonin and melatonin which has a direct connection via the retinohypothalamictract and the suprachiasmatic nucleus between the retina and the pineal gland.



Baglioni C, Nanovska S, Regen W, Spiegelhalder K, Feige B, Nissen C, Reynolds CF, Riemann D. Sleep and Mental Disorders: A meta-analysis of polysomnographic research. Psycholog. Bull. 2016; 42: 969- 90.


Rosenthal NE, Sack DA, Gillin JC, Lewy AJ, Goodwin FK, Davenport Y, Mueller PS, Newsome DA, Wehr TA.Seasonal affective disorder. A description of the syndrome and preliminary findings with light therapy.Arch Gen Psychiatry. 1984 Jan;41(1):72-80.


Terman M, Terman JS, Quitkin FM, McGrath PJ, Stewart JW, Rafferty B.Light Therapy for seasonal affective disorder. A review of efficacy. Neuropsychopharmacology.1989 Mar;2(1):1-22.


August 9, 2018