Actigraphic monitoring of sleep and circadian rest-activity rhythm in individuals with major depressive disorder or depressive symptoms: A meta-analysis

Jun 8, 2024Journal of affective disorders

Sleep and daily activity patterns in people with major depression or depressive symptoms: A combined analysis

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Abstract

A total of 11,115 participants, including 4,000 depressed individuals, were analyzed in this meta-analysis.

Depressed individuals experience significantly longer sleep latency and wake time after sleep onset compared to healthy controls.
They demonstrate lower sleep efficiency and higher frequency of nocturnal awakenings.
Depressed individuals exhibit reduced measures of circadian rhythm, including lower amplitude and stability.
Daytime and total activity levels are significantly less in those with major depressive disorder.

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BACKGROUND: Disrupted sleep and rest-activity pattern are common clinical features in depressed individuals. This meta-analysis compared sleep and circadian rest-activity rhythms in people with major depressive disorder (MDD) or depressive symptoms and healthy controls.

METHODS: Eligible studies were identified in five databases up to December 2023. The search yielded 53 studies with a total of 11,115 participants, including 4000 depressed participants and 7115 healthy controls.

RESULTS: Pooled meta-analyses demonstrated that depressed individuals have significantly longer sleep latency (SMD = 0.23, 95 % CI: 0.12 to 0.33) and wake time after sleep onset (SMD = 0.37, 95 % CI: 0.22 to 0.52), lower sleep efficiency (SMD = -0.41, 95 % CI: -0.56 to -0.25), more nocturnal awakenings (SMD = 0.58, 95 % CI: 0.29 to 0.88), lower MESOR (SMD = -0.54, 95 % CI: -0.81 to -0.28), amplitude (SMD = -0.33, 95 % CI: -0.57 to -0.09), and interdaily stability (SMD = -0.17, 95 % CI: -0.28 to -0.05), less daytime (SMD = -0.79, 95 % CI: -1.08 to -0.49) and total activities (SMD = -0.89, 95 % CI: -1.28 to -0.50) when compared with healthy controls.

LIMITATIONS: Most of the included studies reported separate sleep and activity parameters instead of 24-hour rest-activity rhythms. The variabilities among actigraphy devices and the types of participants recruited also impede precise comparisons.

CONCLUSIONS: The findings emerging from this study offered a better understanding of sleep and rest-activity rhythm in individuals with MDD or depressive symptoms. Future studies could advocate for deriving objective, distinctive 24-hour rest-activity profiles contributing to the risk of depression.

PROSPERO REGISTRATION NUMBER: CRD42021259780.

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Actigraphic monitoring of sleep and circadian rest-activity rhythm in individuals with major depressive disorder or depressive symptoms: A meta-analysis

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