Day-to-day variability in sleep parameters and depression risk: a prospective cohort study of training physicians.
Day-to-day variability in sleep parameters and depression risk: a prospective cohort study of training physicians.
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DOI：
10.1038/s41746-021-00400-z
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发表时间：
2021-02-18
影响因子：
15.2
通讯作者：
Goldstein C
中科院分区：
文献类型：
--
作者：
Fang Y;Forger DB;Frank E;Sen S;Goldstein C
虽然24小时总睡眠时间（TST）被确定为重度抑郁症的关键驱动因素，但睡眠时间和规律性与心理健康之间的关系仍然很差，因为大多数研究依赖于自我报告评估或传统的客观睡眠测量，仅限于横截面时间框架和小队列。为了解决这一差距，我们在医生培训（实习）的第一年通过9项患者健康问卷（PHQ-9）评估了可穿戴设备的睡眠，智能手机应用程序的日常情绪和抑郁症。在2115名实习生中，TST降低（B =-0.11，p < 0.001）、就寝时间较晚（B = 0.068，p = 0.015）、TST变异性增加（B = 0.4，p = 0.0012）和清醒时间变异性增加（B = 0.081，p = 0.005）与更多抑郁症状相关。总体而言，睡眠变异性参数和平均睡眠参数对PHQ-9的综合影响在幅度上相似（均r2 = 0.01）。在个体内，TST增加（B = 0.06，p < 0.001），晚醒时间（B = 0.09，p < 0.001），早睡（B = − 0.07，p < 0.001），以及TST（B = −0.011，p < 0.001）和清醒时间（B = −0.004，p < 0.001）的较低日间变化与第二天情绪的改善相关。睡眠参数的变化对情绪和抑郁有很大影响，其幅度与睡眠参数的平均水平相似。针对睡眠一致性的干预措施，沿着睡眠持续时间，有望改善心理健康。
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 r2 = 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.
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