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Observational Study
. 2024 Oct 15:363:90-98.
doi: 10.1016/j.jad.2024.07.136. Epub 2024 Jul 20.

The relationship between wearable-derived sleep features and relapse in Major Depressive Disorder

F Matcham  1 , E Carr  2 , N Meyer  3 , K M White  4 , C Oetzmann  4 , D Leightley  4 , F Lamers  5 , S Siddi  6 , N Cummins  2 , P Annas  7 , G de Girolamo  8 , J M Haro  6 , G Lavelle  4 , Q Li  7 , F Lombardini  6 , D C Mohr  9 , V A Narayan  10 , B W H J Penninx  3 , M Coromina  6 , G Riquelme Alacid  6 , S K Simblett  11 , R Nica  12 , T Wykes  13 , J C Brasen  7 , I Myin-Germeys  14 , R J B Dobson  2 , A A Folarin  15 , Y Ranjan  2 , Z Rashid  2 , J Dineley  2 , S Vairavan  16 , M Hotopf  17 ; RADAR-CNS consortium  18
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Free article
Observational Study

The relationship between wearable-derived sleep features and relapse in Major Depressive Disorder

F Matcham et al. J Affect Disord. .
Free article

Abstract

Background: Changes in sleep and circadian function are leading candidate markers for the detection of relapse in Major Depressive Disorder (MDD). Consumer-grade wearable devices may enable remote and real-time examination of dynamic changes in sleep. Fitbit data from individuals with recurrent MDD were used to describe the longitudinal effects of sleep duration, quality, and regularity on subsequent depression relapse and severity.

Methods: Data were collected as part of a longitudinal observational mobile Health (mHealth) cohort study in people with recurrent MDD. Participants wore a Fitbit device and completed regular outcome assessments via email for a median follow-up of 541 days. We used multivariable regression models to test the effects of sleep features on depression outcomes. We considered respondents with at least one assessment of relapse (n = 218) or at least one assessment of depression severity (n = 393).

Results: Increased intra-individual variability in total sleep time, greater sleep fragmentation, lower sleep efficiency, and more variable sleep midpoints were associated with worse depression outcomes. Adjusted Population Attributable Fractions suggested that an intervention to increase sleep consistency in adults with MDD could reduce the population risk for depression relapse by up to 22 %.

Limitations: Limitations include a potentially underpowered primary outcome due to the smaller number of relapses identified than expected.

Conclusion: Our study demonstrates a role for consumer-grade activity trackers in estimating relapse risk and depression severity in people with recurrent MDD. Variability in sleep duration and midpoint may be useful targets for stratified interventions.

Keywords: Longitudinal; Major Depressive Disorder; Sleep; Wearable technology.

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Conflict of interest statement

Declaration of competing interest HE was a full-time employee of H. Lundbeck A/S and held stock and stock options in H. Lundbeck A/S at the time of study conduct. QL, SV and VN were employees of Janssen Research & Development, LLC and held company stocks/stock options at the time of study conduct. JMH has received economic compensation for participating in advisory boards or giving educational lectures from Eli Lilly & Co, Sanofi, Lundbeck, and Otsuka. No other authors have competing interests to declare.

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