Cabanel Nicole, Schmidt Anne-Marthe, Fockenberg Stanislava, Brückmann Konstantin, Müller Matthias J, Kundermann Bernd, Haag Anja
Vitos Clinic for Psychiatry and Psychotherapy Giessen, Giessen, Germany.
Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany.
Chronobiol Int. 2022 Feb;39(2):249-260. doi: 10.1080/07420528.2021.1994583. Epub 2021 Nov 1.
Major depressive disorder (MDD) is frequently accompanied by sleep disturbance. Regarding diurnal preference (chronotype), sleep problems and low mood have been associated with evening orientation. Considering diurnal preference, we investigated subjective restorative value of sleep and actigraphy sleep parameters together with mood assessments twice a day, i.e. in the morning and evening, during weekdays and weekends in MDD psychiatric inpatients and healthy controls (HCs). The restorative value of sleep was higher during the weekend in HC, and bedtimes and risetimes were delayed during the weekend compared to weekdays in HC and MDD. Morning mood affected subjective sleep ratings in both groups, while association with symptom severity (BDI) in MDD remained insignificant. In HC, better evening mood was associated with later bedtimes. Regarding the chronotype in HC, evening orientation was associated with relatively low restorative value of sleep during weekdays, and morning orientation was associated with relatively higher actigraphy sleep efficiency during weekdays compared to weekend. In MDD, an association of evening orientation with later rise times could be observed, while no chronotype dependent effect emerged regarding the restorative value of sleep or sleep efficiency. Our results emphasize that research on sleep in MDD should incorporate weekdays as well as weekends, chronotype assessment, and measures of morning and evening mood, as these can be associated with ratings of the subjective restorative value of sleep (i.e. in our study, better morning mood was associated with higher restorative values), but also with behavioral sleep parameters (i.e. in our study, more positive evening mood was associated with later bedtimes). Potentially, the restorative value of sleep in MDD evening types can be improved by maintaining a regular sleep schedule, which needs to be investigated in an experimental design.
重度抑郁症（MDD）常伴有睡眠障碍。关于昼夜偏好（生物钟类型），睡眠问题和情绪低落与晚睡倾向有关。考虑到昼夜偏好，我们对MDD精神科住院患者和健康对照者（HCs）在工作日和周末每天早晚两次进行了睡眠主观恢复价值、活动记录仪睡眠参数以及情绪评估的调查。HCs在周末睡眠的恢复价值更高，与工作日相比，HCs和MDD患者在周末的就寝时间和起床时间都延迟了。早晨情绪影响两组的主观睡眠评分，而与MDD症状严重程度（BDI）的关联仍不显著。在HCs中，晚上情绪较好与较晚的就寝时间有关。关于HCs的生物钟类型，晚睡倾向与工作日睡眠相对较低的恢复价值有关，与周末相比，早睡倾向与工作日相对较高的活动记录仪睡眠效率有关。在MDD患者中，可以观察到晚睡倾向与较晚的起床时间有关，而在睡眠恢复价值或睡眠效率方面未出现依赖于生物钟类型的效应。我们的结果强调，对MDD睡眠的研究应纳入工作日和周末、生物钟类型评估以及早晚情绪测量，因为这些不仅可能与睡眠主观恢复价值的评分相关（即，在我们的研究中，早晨情绪较好与较高的恢复价值相关），还与行为睡眠参数相关（即，在我们的研究中，晚上情绪更积极与较晚的就寝时间相关）。潜在地，通过保持规律的睡眠时间表可以改善MDD晚睡类型患者的睡眠恢复价值，这需要在实验设计中进行研究。
