Temporal sleep patterns between healthy and depressed individuals


  • Mohammad A. Alotaibi University of Sydney
  • Mark Halaki University of Sydney
  • Chin Moi Chow University of Sydney






Actigraphy, Depressive Symptoms, Physical Activity, Sleep Onset Latency.


Background: Individuals with depression differ in their sleep patterns from healthy subjects. However, there are no studies that compare the temporal sleep patterns between healthy and depressed people or explore the relations between depressive symptomatology and physical activity levels. This study is an attempt to address this gap.

Method: Participants recruited were 20 healthy and 20 depressed individuals. Data related to sleep-wake patterns, and activity levels were collected over four weeks using actigraph device (Actiwatch 2) and depressive symptoms were collected using the Depression Anxiety and Stress Scale (DASS) and Quick Inventory of Depressive Symptoms (QIDS) questionnaire. The data for the two groups were compared using t-tests. Correlation analyses were employed to test for associations between depressive symptoms, activity level and sleep patterns for each group.

Result: The depressed group had significantly higher scores for depression, longer total sleep time, and lower level of activity compared to the healthy group. Sleep onset latency (SOL) was significantly correlated with the anxiety subscale of DASS, the depression score as measured by QIDS, and the activity level in the depressed group. The positive association between activity level and SOL was anomalous, and did not reflect the expected pattern seen in healthy individuals.

Conclusion: The depressed group was confirmed to have significantly higher levels of depression, stress and anxiety, and lower level of physical activity. Increased anxiety and depression predicted delayed sleep onset. Depressive symptoms may have masked the expected relation between physical activity and SOL seen in healthy individuals.


lang=EN-AU style='font-size:10.0pt;mso-ascii-font-family:"Times New Roman";

mso-ascii-theme-font:major-bidi;mso-hansi-font-family:"Times New Roman";

mso-hansi-theme-font:major-bidi;mso-bidi-font-family:"Times New Roman";


style='mso-spacerun:yes'> ADDIN EN.REFLIST


[1] Edéll-Gustafsson, U., Sleep, psychological symptoms and quality of life in patients undergoing coronary artery bypass grafting. Nordic Journal of Psychiatry, 1999. 53(2): p. 159-162. https://doi.org/10.1080/080394899426882.

[2] Pilcher, J.J., D.R. Ginter, and B. Sadowsky, Sleep quality versus sleep quantity: relationships between sleep and measures of health, well-being and sleepiness in college students. Journal of psychosomatic research, 1997. 42(6): p. 583-596. https://doi.org/10.1016/S0022-3999(97)00004-4.

[3] Riemann, D., Berger M, and U. Voderholzer, Sleep and depression a results from psychobiological studies: an overview. Biol Psychol 2001. 57((1-3)): p. 76-103. https://doi.org/10.1016/S0301-0511(01)00090-4.

[4] Heslop, P., et al., Sleep duration and mortality: the effect of short or long sleep duration on cardiovascular and all-cause mortality in working men and women. Sleep medicine, 2002. 3(4): p. 305-314. https://doi.org/10.1016/S1389-9457(02)00016-3.

[5] Owens, J.A., Sleep loss and fatigue in healthcare professionals. The Journal of perinatal & neonatal nursing, 2007. 21(2): p. 92-100. https://doi.org/10.1097/01.JPN.0000270624.64584.9d.

[6] Benca, R.M., et al., Sleep and mood disorders. Sleep medicine reviews, 1997. 1(1): p. 45-56. https://doi.org/10.1016/S1087-0792(97)90005-8.

[7] Levy, P., et al., Sleep deprivation, sleep apnea and cardiovascular diseases. Frontiers in bioscience (Elite edition), 2011. 4: p. 2007-2021.

[8] Patel, S.R. and F.B. Hu, Short sleep duration and weight gain: a systematic review. Obesity, 2008. 16(3): p. 643-653. https://doi.org/10.1038/oby.2007.118.

[9] Jansson-Fröjmark, M. and K. Lindblom, A bidirectional relationship between anxiety and depression, and insomnia? A prospective study in the general population. Journal of psychosomatic research, 2008. 64(4): p. 443-449. https://doi.org/10.1016/j.jpsychores.2007.10.016.

[10] Gupta, R., S. Dahiya, and M.S. Bhatia, Effect of depression on sleep: Qualitative or quantitative? Indian journal of psychiatry, 2009. 51(2): p. 117-121. https://doi.org/10.4103/0019-5545.49451.

[11] Gupta, M.A., F.C. Simpson, and D.C. Lyons, The effect of treating obstructive sleep apnea with positive airway pressure on depression and other subjective symptoms: A systematic review and meta-analysis. Sleep medicine reviews, 2016. 28: p. 55-68. https://doi.org/10.1016/j.smrv.2015.07.002.

[12] Lang, C., et al., The relationship between physical activity and sleep from mid adolescence to early adulthood. A systematic review of methodological approaches and meta-analysis. Sleep medicine reviews, 2016. 28: p. 32-45. https://doi.org/10.1016/j.smrv.2015.07.004.

[13] Baumgartner, A. and N. Sucher, The influence of physical activity and posture on the antidepressant effect of sleep deprivation in depressed patients. Journal of affective disorders, 1990. 20(2): p. 93-99. https://doi.org/10.1016/0165-0327(90)90122-O.

[14] Respironics, Actiwatch Communication and Sleep Analysis Software with ActiReader: Actiware and Actiware CT Software and Hardware Manual. Murrysville, ed. P. Respironics. 2009, Murrysville, PA; 2009.

[15] Matuzaki, L., et al., Temporal sleep patterns in adults using actigraph. Sleep Science, 2014. 7(3): p. 152-157. https://doi.org/10.1016/j.slsci.2014.09.012.

[16] Irwin, M., T.L. Smith, and J.C. Gillin, Electroencephalographic sleep and natural killer activity in depressed patients and control subjects. Psychosomatic Medicine, 1992. 54(1): p. 10-21. https://doi.org/10.1097/00006842-199201000-00002.

[17] Robillard, R., et al., Delayed sleep phase in young people with unipolar or bipolar affective disorders. Journal of affective disorders, 2013. 145(2): p. 260-263. https://doi.org/10.1016/j.jad.2012.06.006.

[18] Borbély, A. and A. Wirz-Justice, Sleep, sleep deprivation and depression. Hum Neurobiol, 1982. 1(205): p. 10.

[19] Giedke, H. and F. Schwarzler, Therapeutic use of sleep deprivation in depression. Sleep Medicine Reviews, 2002. 6(5): p. 361-77. https://doi.org/10.1016/S1087-0792(02)90235-2.

[20] Vogel, G.W., et al., Improvement of depression by REM sleep deprivation: new findings and a theory. Archives of General Psychiatry, 1980. 37(3): p. 247-253. https://doi.org/10.1001/archpsyc.1980.01780160017001.

[21] Bonnet, M.H. and D.L. Arand, We are chronically sleep deprived. SLEEP-NEW YORK-, 1995. 18: p. 908-911.

[22] Roane, B.M., et al., The link between sleep disturbance and depression among Mexican Americans: a Project FRONTIER study. Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine, 2014. 10(4): p. 427-431.

[23] Gunnarsdóttir, K., Effects of Poor Subjective Sleep Quality on Symptoms of Depression and Anxiety among Adolescents. 2014.

[24] Sivertsen, B., et al., The bidirectional association between depression and insomnia: the HUNT study. Psychosomatic medicine, 2012. 74(7): p. 758-765. https://doi.org/10.1097/PSY.0b013e3182648619.

[25] Roberts, N.P., et al., Multiple session early psychological interventions for the prevention of post-traumatic stress disorder. Cochrane Database of Systematic Reviews, 2010(4): p. 1-43.

[26] Mansfield, R., Sleep as a Remedy for Stress: the Sleep Response at a Cellular Level. 2015, California State University, Northridge.

[27] Murphy, M.J. and M.J. Peterson, Sleep disturbances in depression. Sleep medicine clinics, 2015. 10(1): p. 17-23. https://doi.org/10.1016/j.jsmc.2014.11.009.

[28] Reid, K.J., et al., Aerobic exercise improves self-reported sleep and quality of life in older adults with insomnia. Sleep medicine, 2010. 11(9): p. 934-940. https://doi.org/10.1016/j.sleep.2010.04.014.

[29] Strawbridge, W.J., et al., Physical activity reduces the risk of subsequent depression for older adults. American journal of epidemiology, 2002. 156(4): p. 328-334. https://doi.org/10.1093/aje/kwf047.

[30] Li, Y.-N., et al., Association between quality of life and anxiety, depression, physical activity and physical performance in maintenance hemodialysis patients. Chronic Diseases and Translational Medicine, 2016. 2(2): p. 110-119. https://doi.org/10.1016/j.cdtm.2016.09.004.

[31] McDowell, C.P., C. MacDonncha, and M.P. Herring, Brief report: Associations of physical activity with anxiety and depression symptoms and status among adolescents. Journal of Adolescence, 2017. 55: p. 1-4. https://doi.org/10.1016/j.adolescence.2016.12.004.

[32] McMahon, E.M., et al., Physical activity in European adolescents and associations with anxiety, depression and well-being. European child & adolescent psychiatry, 2017. 26(1): p. 111-122. https://doi.org/10.1007/s00787-016-0875-9.

[33] Youngstedt, S.D. and J.D. Freelove-Charton, Exercise and sleep. Exercise, Health, and Mental Health: Emerging Relationships. New York, NY: Routledge, 2005: p. 159-189.

[34] Youngstedt, S.D., P.J. O’Connor, and R.K. Dishman, from wake to sleep. The effects of acute exercise on sleep: a quantitative synthesis. Sleep, 1997. 20(3): p. 203-214.

"Times New Roman","serif";mso-ascii-theme-font:major-bidi;mso-fareast-font-family:

"Times New Roman";mso-hansi-theme-font:major-bidi;mso-bidi-theme-font:major-bidi;



View Full Article: