(247) Day-to-Day Variability in Sleep Parameters and Sleep Impairment Among Adolescents With Mood Disorders Treated With Antidepressants

Publication Number: 580

Background: Previous work has shown that altered sleep patterns and impairment due to sleep can be an indicator of mood disorders. Among adolescents with mood disorders a lack of objective, real-time data, limits our understanding of sleep patterns, their variability, and impact while on treatment with antidepressants.

Objectives: To estimate differences in sleep duration, variability, and impairment due to sleep, between adolescents with mood disorders on antidepressant treatment when compared to untreated controls.

Methods: Prospective longitudinal study of a convenience sample of 31 adolescents (12-17 years) with (mood -n=20) and without (control- n=11) mood disorders. Over the 28 days of the study, objective real time assessment of total daily sleep was captured through an accelerometry-based wearable device (Fitbit Inspire HR®). Sleep impairment was measured at baseline and end of study using T-scores derived from PROMIS® Pediatric Sleep Related Impairment questionnaire (v. 1.0; 8b) which captures self-reported alertness, sleepiness, tiredness, and functional impairments associated with sleep problems during waking hours. Data on socio-demographics, clinical characteristics, and daily antidepressant medication intake, was measured at baseline. We examined mean levels and variation of total daily sleep and sleep impairment using descriptive statistics as well as linear mixed models clustering longitudinal measures at the participant level.

Results: Adolescents in the mood group on average (Mean, %) contributed fewer nights of data when compared to controls (13.1 [47%] compared to 20.8 [74%] nights, respectively) for a total of 649 measures of sleep. Mean daily sleep, did not vary between mood and controls [6.9 h (SD 2.35) vs 6.8 h (SD 1.89) respectively; p = 0.6]. Longer daily sleep was observed among adolescents ages 15 years and above, and during school session (when compared to summer). Mood group participants reported higher sleep impairment when compared to controls (T-score 60.2 vs 44.14, respectively). Higher daily sleep variability was observed among adolescents in the mood group and associated with higher sleep impairment scores.

Conclusions: Results demonstrate the feasibility and acceptability of using wearable technologies to assess time-varying measures relevant to sleep in adolescents with mood disorders. Passive and active monitoring of sleep measures could provide evidence on treatment response and support clinical-decision making. Personalized strategies to improve consistent use of wearable technologies among patient populations who experience symptoms that can impact device adherence is needed.