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

Published online by Cambridge University Press:  17 December 2019

Marko Elovainio Open the ORCID record for Marko Elovainio [Opens in a new window] ,
Jari Lipsanen ,
Risto Halonen ,
Liisa Kuula ,
Katri Räikkönen  and
Anu-Katriina Pesonen
Marko Elovainio*
Affiliation:
National Institute for Health and Welfare, Helsinki, Finland SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
Jari Lipsanen
Affiliation:
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
Risto Halonen
Affiliation:
SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
Liisa Kuula
Affiliation:
SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
Katri Räikkönen
Affiliation:
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Helsinki, Finland
Anu-Katriina Pesonen
Affiliation:
SleepWell Research Program, Faculty of Medicine, University of Helsinki, Helsinki, Finland
*
Author for correspondence: Marko Elovainio, E-mail: marko.elovainio@helsinki.fi
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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.

Keywords

AdolescencesleepEEGNREMREMdepressionMarkov chain
Type
Original Articles
Information
Psychological Medicine , Volume 51 , Issue 3 , February 2021 , pp. 426 - 434
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Copyright
Copyright © Cambridge University Press 2019

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