Day-to-day variability in sleep parameters and depression risk: a prospective cohort study of training physicians
Abstract While 24-h total sleep time (TST) is established as a critical driver of major depression, the relationships between sleep timing and regularity and mental health remain poorly characterized because most studies have relied on either self-report assessments or traditional objective sleep me...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2021-02-01
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| Series: | npj Digital Medicine |
| Online Access: | https://doi.org/10.1038/s41746-021-00400-z |
| _version_ | 1797430161888509952 |
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| author | Yu Fang Daniel B. Forger Elena Frank Srijan Sen Cathy Goldstein |
| author_facet | Yu Fang Daniel B. Forger Elena Frank Srijan Sen Cathy Goldstein |
| author_sort | Yu Fang |
| collection | DOAJ |
| description | Abstract While 24-h total sleep time (TST) is established as a critical driver of major depression, the relationships between sleep timing and regularity and mental health remain poorly characterized because most studies have relied on either self-report assessments or traditional objective sleep measurements restricted to cross-sectional time frames and small cohorts. To address this gap, we assessed sleep with a wearable device, daily mood with a smartphone application and depression through the 9-item Patient Health Questionnaire (PHQ-9) over the demanding first year of physician training (internship). In 2115 interns, reduced TST (b = −0.11, p < 0.001), later bedtime (b = 0.068, p = 0.015), along with increased variability in TST (b = 0.4, p = 0.0012) and in wake time (b = 0.081, p = 0.005) were associated with more depressive symptoms. Overall, the aggregated impact of sleep variability parameters and of mean sleep parameters on PHQ-9 were similar in magnitude (both r 2 = 0.01). Within individuals, increased TST (b = 0.06, p < 0.001), later wake time (b = 0.09, p < 0.001), earlier bedtime (b = − 0.07, p < 0.001), as well as lower day-to-day shifts in TST (b = −0.011, p < 0.001) and in wake time (b = −0.004, p < 0.001) were associated with improved next-day mood. Variability in sleep parameters substantially impacted mood and depression, similar in magnitude to the mean levels of sleep parameters. Interventions that target sleep consistency, along with sleep duration, hold promise to improve mental health. |
| first_indexed | 2024-03-09T09:24:36Z |
| format | Article |
| id | doaj.art-fe521c3e0ca747da8672a7fac84a79b3 |
| institution | Directory Open Access Journal |
| issn | 2398-6352 |
| language | English |
| last_indexed | 2024-03-09T09:24:36Z |
| publishDate | 2021-02-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | npj Digital Medicine |
| spelling | doaj.art-fe521c3e0ca747da8672a7fac84a79b32023-12-02T06:49:25ZengNature Portfolionpj Digital Medicine2398-63522021-02-01411910.1038/s41746-021-00400-zDay-to-day variability in sleep parameters and depression risk: a prospective cohort study of training physiciansYu Fang0Daniel B. Forger1Elena Frank2Srijan Sen3Cathy Goldstein4Michigan Neuroscience Institute, University of MichiganDepartment of Mathematics, University of MichiganMichigan Neuroscience Institute, University of MichiganMichigan Neuroscience Institute, University of MichiganDepartment of Neurology, University of MichiganAbstract While 24-h total sleep time (TST) is established as a critical driver of major depression, the relationships between sleep timing and regularity and mental health remain poorly characterized because most studies have relied on either self-report assessments or traditional objective sleep measurements restricted to cross-sectional time frames and small cohorts. To address this gap, we assessed sleep with a wearable device, daily mood with a smartphone application and depression through the 9-item Patient Health Questionnaire (PHQ-9) over the demanding first year of physician training (internship). In 2115 interns, reduced TST (b = −0.11, p < 0.001), later bedtime (b = 0.068, p = 0.015), along with increased variability in TST (b = 0.4, p = 0.0012) and in wake time (b = 0.081, p = 0.005) were associated with more depressive symptoms. Overall, the aggregated impact of sleep variability parameters and of mean sleep parameters on PHQ-9 were similar in magnitude (both r 2 = 0.01). Within individuals, increased TST (b = 0.06, p < 0.001), later wake time (b = 0.09, p < 0.001), earlier bedtime (b = − 0.07, p < 0.001), as well as lower day-to-day shifts in TST (b = −0.011, p < 0.001) and in wake time (b = −0.004, p < 0.001) were associated with improved next-day mood. Variability in sleep parameters substantially impacted mood and depression, similar in magnitude to the mean levels of sleep parameters. Interventions that target sleep consistency, along with sleep duration, hold promise to improve mental health.https://doi.org/10.1038/s41746-021-00400-z |
| spellingShingle | Yu Fang Daniel B. Forger Elena Frank Srijan Sen Cathy Goldstein Day-to-day variability in sleep parameters and depression risk: a prospective cohort study of training physicians npj Digital Medicine |
| title | Day-to-day variability in sleep parameters and depression risk: a prospective cohort study of training physicians |
| title_full | Day-to-day variability in sleep parameters and depression risk: a prospective cohort study of training physicians |
| title_fullStr | Day-to-day variability in sleep parameters and depression risk: a prospective cohort study of training physicians |
| title_full_unstemmed | Day-to-day variability in sleep parameters and depression risk: a prospective cohort study of training physicians |
| title_short | Day-to-day variability in sleep parameters and depression risk: a prospective cohort study of training physicians |
| title_sort | day to day variability in sleep parameters and depression risk a prospective cohort study of training physicians |
| url | https://doi.org/10.1038/s41746-021-00400-z |
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