Is moderate depression associated with sleep stage architecture in adolescence? Testing the stage type associations using network and transition probability approaches

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Abstract

Background
Depression even at the subclinical level is often accompanied by sleep disturbances, but little is known about the dynamics of the sleep stages in relation to depressive symptoms. We examined whether the amount, associations, and transition probabilities of various sleep stages were associated with depressive symptoms in a community sample of adolescents.

Methods
The participants (N = 172, 59% girls, mean age 16.9 years) underwent overnight polysomnography and provided data on depressive symptoms (Beck Depression Inventory II). The association between depression status and total duration of each stage type was analyzed using ANOVA and survival analyses. The associations between the number of different sleep stage types were analyzed using graphical Gaussian models, mixed graphical models, and relative importance networks. A Markov chain algorithm was used to estimate the transition probabilities between each state and these probabilities were further compared between depression status groups.

Results
The associations between N1 and N3 were significantly stronger in both directions of the association (p-values for interactions 0.012 and 0.006) in those with more depressive symptoms. Similarly, a stronger association was observed from N1 to wake stage in those with more depressive symptoms (p-value for interaction 0.002). In those with more depressive symptoms, it was more likely to transition from N2 to N3 and from REM to N2 compared to others.

Conclusions
These findings indicate that changes in sleep architecture are not limited to clinical depression and that the transitional dynamics of sleep stages are an important marker of subclinical depression.
Original languageEnglish
Article number0033291719003453
JournalPsychological Medicine
Volume51
Issue number3
Pages (from-to)426-434
Number of pages9
ISSN0033-2917
DOIs
Publication statusPublished - Feb 2021
MoE publication typeA1 Journal article-refereed

Fields of Science

  • Adolescence
  • sleep
  • EEG
  • NREM
  • REM
  • depression
  • Markov chain
  • 515 Psychology

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