Laboratório de Cronobiologia e Sono, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre/RS, Brazil.
Graduate Program in Psychiatry and Behavioral Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre/RS, Brazil.
Sleep. 2022 Jul 11;45(7). doi: 10.1093/sleep/zsac104.
Major depressive disorder (MDD) in adolescence is associated with irregularities in circadian rhythms and sleep. The characterization of such impairment may be critical to design effective interventions to prevent development of depression among adolescents. This study aimed to examine self-reported and actimetry-based circadian rhythms and sleep-wake behavior associated with current MDD and high risk (HR) for MDD among adolescents.
Ninety-six adolescents who took part in the IDEA-RiSCo study were recruited using an empirically developed depression-risk stratification method: 26 classified as low risk (LR), 31 as HR, and 39 as a current depressive episode (MDD). We collected self-report data on insomnia, chronotype, sleep schedule, sleep hygiene as well as objective data on sleep, rest-activity, and light exposure rhythms using actimetry for 10 days.
Adolescents with MDD exhibited more severe insomnia, shorter sleep duration, higher social jetlag (SJL), lower relative amplitude (RA) of activity, and higher exposure to artificial light at night (ALAN) compared with the other groups. They also presented poorer sleep hygiene compared with the LR group. The HR group also showed higher insomnia, lower RA, higher exposure to ALAN, and higher SJL compared with the LR group.
HR adolescents shared sleep and rhythm alterations with the MDD group, which may constitute early signs of depression, suggesting that preventive strategies targeting sleep should be examined in future studies. Furthermore, we highlight that actimetry-based parameters of motor activity (particularly RA) and light exposure are promising constructs to be explored as tools for assessment of depression in adolescence.
青少年时期的重度抑郁症(MDD)与昼夜节律和睡眠不规律有关。这种障碍的特征对于设计有效的干预措施以防止青少年抑郁的发展可能至关重要。本研究旨在检查与当前 MDD 和青少年 MDD 高风险(HR)相关的自我报告和基于活动记录仪的昼夜节律和睡眠-觉醒行为。
使用经验开发的抑郁风险分层方法招募了 96 名参加 IDEA-RiSCo 研究的青少年:26 名被归类为低风险(LR),31 名 HR,39 名为当前抑郁发作(MDD)。我们收集了 10 天的自我报告数据,包括失眠、生物钟类型、睡眠时间表、睡眠卫生以及使用活动记录仪记录的睡眠、休息-活动和光照暴露节律的客观数据。
与其他组相比,患有 MDD 的青少年表现出更严重的失眠、睡眠时间更短、社会时差(SJL)更高、活动相对幅度(RA)更低、夜间人工光照(ALAN)暴露更高。与 LR 组相比,他们的睡眠卫生也更差。与 LR 组相比,HR 组还表现出更高的失眠、更低的 RA、更高的 ALAN 暴露和更高的 SJL。
HR 青少年与 MDD 组共享睡眠和节律改变,这可能构成抑郁的早期迹象,表明未来的研究应检查针对睡眠的预防策略。此外,我们强调基于活动记录仪的运动活动(特别是 RA)和光照暴露参数是作为评估青少年抑郁的工具进行探索的有前途的结构。