Abstract
Considering the marked changes in sleep and circadian rhythms across the lifespan, age may contribute to the heterogeneity in sleep-wake profiles linked to mood disorders. This study aimed to investigate the contributions of age and depression severity to sleep-wake disturbances. The Hamilton Depression Rating Scale (HDRS) was administered to assess current symptoms severity in 238 persons with a history of a mood disorder between 12 and 90 years of age (y.o.). Actigraphy was recorded over five to 22 days. Regression analyses and analyses of variance [age (12–19 y.o., 20–39 y.o., 40–59 y.o., and ≥60 y.o.) by depression severity (HDRS< and ≥8)] were conducted. The 12–19 y.o. and 20–39 y.o. groups had a delayed sleep schedule and acrophase compared to all other groups. The ≥60 y.o. group had a lower rhythmicity and amplitude (p≤.006) than the 12–19 y.o. group (p≤.046). Participants with a HDRS≥8 spent longer time in bed, had later sleep offset times and had lower circadian rhythmicity than those with a HDRS<8 (p≤.036). Younger age and higher HDRS score correlated with later sleep onset and offset times, longer time in bed, higher WASO, lower sleep efficiency and later acrophase (p≤.023). Age was a significant predictor of delayed sleep and activity schedules (p≤.001). The profile of sleep-wake cycle disturbances associated with mood disorders changes with age, with prominent sleep phase delay during youth and reduced circadian strength in older persons. Conversely, disruptions in sleep consolidation seem more stable across age.
Highlights
An increasing body of evidence suggests that the symptomatology and pathophysiological profile of depression during youth differs to that seen during old age, notably in terms of genetic and vascular factors, as well as cognitive impairment [1,2,3,4]
Despite the potential role of sleep-wake disturbances in the pathogenesis and maintenance of mood disorders and the extensive changes in the sleep-wake cycle across the lifespan, little attention has yet been given to the potential interactions between depressive illness and sleep-wake cycle modifications across various ages
Two were from the 12– 19 y.o. group, three from the 20–39 y.o. group, five from the 40– 59 y.o. group and six from the $60 y.o. group. Seven of these were from the asymptomatic group and seven from the symptomatic group
Summary
An increasing body of evidence suggests that the symptomatology and pathophysiological profile of depression during youth differs to that seen during old age, notably in terms of genetic and vascular factors, as well as cognitive impairment [1,2,3,4]. Apathy and daytime fatigue are hallmark features of depressive syndromes [5] and are likely to result from, and be further exacerbated by, sleep-wake disturbances. Low energy levels, fatigue and apathy may decrease the motivation to engage in an active lifestyle. This may, in turn, perpetuate sleep-wake problems and fatigue by negating the potential benefits of exercise for sleep [10,11,12,13] and its synchronising effects on the biological clock [14,15]
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