Disturbances to sleep-wake behavior are commonly reported in patients with depression. These changes include disruption to sleep-wake timing, reduced sleep consolidation, alterations in sleep architecture, reduced sleep quality and high levels of daytime sleepiness. The relationship between sleep-wake behavior and depression is not well established, and the role that sleep disturbances play in the pathophysiology of depression is not well understood. The sleep-wake disturbances may contribute significantly to the impairment of daily functioning, increased fatigue levels and reduced quality of life. Treating these symptoms, while concurrently treating the primary symptoms of depression may enhance overall management.

We hypothesise that the stabilisation of sleep-wake patterns will reduce depressive symptomseverity, and delay the onset of relapse. Management of sleep-wake and circadian disturbances can be achieved using a number of behavioral and pharmacological options, including bright light exposure, structured sleep-wake timing and compounds such as melatonin or melatonin agonists.