Using a wrist-worn actigraphy device, researchers found that people with current depression and/or anxiety had reduced physical activity and more circadian rhythm disturbances than controls, researchers reported in Depression & Anxiety.
Over a 2-week period, actigraphy monitoring provided ecologically valid, objective differences in sleep, circadian rhythm and physical activity measures between diagnostic groups that were not seen with selfreported questionnaires, according to study results.
“A better understanding on the association of sleep, [circadian rhythm and physical activity] with psychopathology that may have important clinical implications, in particular for the clinical assessment, monitoring and treatment of depression and anxiety,” Sonia Difrancesco, PhD candidate at the Amsterdam Public Health Research Institute, and colleagues wrote.
Researchers examined 2-week actigraphy data from 359 participants with current (n = 93), remitted (n = 176) or no (n = 90) depression/anxiety diagnoses to determine whether actigraphy offers a better assessment of sleep, circadian rhythm and physical activity than selfreported questionnaires,
Participants wore actigraphy devices, took part in the Ecological Momentary Assessment on smartphones and answered questions on current mood states. Objective estimates were sleep duration, sleep efficiency, relative amplitude between daytime and nighttime activity, mid-sleep on free days, gross motor activity and moderatetovigorous physical activity. Selfreported measures were insomnia rating scale, sleep duration, mid-sleep on free days, metabolic equivalent total and moderatetovigorous physical activity.
The depressive/anxiety disorder group was heterogeneous: 38.3% had anxiety disorders only, 28.7% had depressive disorders only and 33% had both disorders.
Using actigraphy, the investigators found that individuals with current depressive and/or anxiety disorders had significantly different objective — but not self-reported — physical activity and circadian rhythm measures, including lower gross motor activity (23.83 vs. 27.4 milligravity/day; P = .022), lower moderatetovigorous physical activity (35.32 vs. 47.64 minutes/day; P = .023) and lower relative amplitude (0.82 vs. 0.83; P = .033). However, self-reported — but not objective — sleep measures differed between people with current depression/anxiety and those without, with individuals with depression/anxiety reporting both shorter and longer sleep duration and more insomnia.
In addition, Difrancesco and colleagues reported that people with greater severity of depressive/anxiety symptoms and more psychiatric comorbidity exhibited lower physical activity and more circadian rhythm disturbances.
“As the correlations of actigraphy estimates with selfreport measures were generally low, actigraphy monitoring was shown to provide an easy and noninvasive approach to capture objective information regarding both nighttime sleep and daytime activity, and, sleep and [circadian rhythm],” they wrote. “While this study confirms the feasibility and acceptability of monitoring patients, more research is needed to establish whether actigraphy could, possibly, in the future, play a role in monitoring treatment response to such interventions.” – by Savannah Demko
Disclosure: Difrancesco reports grants from Innovative Medicines Initiative 2 Joint. Please see the study for all other authors’ relevant financial disclosures.