24-HOUR ACTIVITY RHYTHM AND SLEEP DISTURBANCES IN DEPRESSION AND ANXIETY: A POPULATION-BASED STUDY OF MIDDLE-AGED AND OLDER PERSONS: Research Article: Rhythms, Sleep, Depression, and Anxiety
Open accessAbstract
BACKGROUND: Disturbed circadian rhythms have been associated with depression and anxiety, but it is unclear if disturbances in the 24-hr activity rhythm and sleep are independently and specifically related to these disorders. METHODS: In 1,714 middle-aged and elderly participants of the Rotterdam Study, we collected actigraphy recordings of at least 96 hr (138 ± 14 hr, mean ± standard deviation). Activity rhythms were quantified calculating the fragmentation of the rhythm, stability of the rhythm over days, and timing of the rhythm. Total sleep time, sleep onset latency, and wake after sleep onset were also estimated with actigraphy. Depressive symptoms were assessed with the Center for Epidemiologic Studies Depression scale, persons with clinically relevant depressive symptoms were interviewed to diagnose DSM-IV-depressive disorder. Anxiety disorders were determined with the Munich version of the Composite International Diagnostic Interview. RESULTS: More fragmented rhythms were associated with clinically relevant depressive symptoms (odds ratio (OR): 1.27, 95% confidence interval (CI): 1.04;1.54) and anxiety disorders (OR: 1.39, 95% CI: 1.14;1.70) after covariate adjustment. Less stable rhythms, longer sleep onset latency, and more wake after sleep onset were related to clinically relevant depressive symptoms or anxiety disorders only if not adjusted for covariates and other activity rhythm and sleep indicators. CONCLUSIONS: Our study in middle-aged and elderly persons suggests that fragmentation of the 24-hr activity rhythm is associated with depression and anxiety. Moreover, this association also largely accounts for the effect of disturbed sleep on these psychiatric disorders.
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People with clinically significant depressive symptoms have lower interdaily stability (IS) and higher intradaily variability (IV) of circadian activity rhythm.
“Few studies using nonparametric rhythm measures demonstrated that participants with more severe depressive symptoms had lower interdaily stability (IS) and higher intradaily variability (IV) of circadian activity rhythm [31,34], reduced relative amplitude (RA) between the highest and the lowest activity levels [28,35], and reduced RA of skin temperature [36].”
From Digital Biomarkers for Depression Screening With Wearable Devices: Cross-sectional Study With Machine Learning Modeling (2021) · cites this paper as [34]
A lower steps-based weekday IS was robustly associated with a greater severity of depressive symptoms independent of confounders.
“we found that a lower steps-based weekday IS—a nonparametric measure of rhythm regularity—was robustly associated with a greater severity of depressive symptoms independent of confounders”
From Digital Biomarkers for Depression Screening With Wearable Devices: Cross-sectional Study With Machine Learning Modeling (2021) · cites this paper as [34]
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- Authors
- Luik, A. I., Zuurbier, L. A., Direk, N., Hofman, A., Van Someren, E. J. W., & Tiemeier, H.
- Affiliations
- Erasmus MC (NL)
- Department of Epidemiology; Erasmus University Medical Center; Rotterdam The Netherlands
- Department of Sleep and Cognition; Netherlands Institute for Neuroscience, Royal Academy of Arts and Sciences; Amsterdam The Netherlands
- Corresponding author
- Tiemeier, Henning
- Venue
- Depression and Anxiety
- Publisher
- Wiley
- Published
- 2015-02-18
- Volume
- 32
- Issue
- 9
- Pages
- 684-692
- ISSN
- 1091-4269 (ISSN-L)
- OpenAlex
- W1953563484
- Cited by
- 120
- References
- 51
- Citations by year
- 2026: 7 · 2025: 7 · 2024: 16 · 2023: 17 · 2022: 15 · 2021: 10 · 2020: 12 · 2019: 8 · 2018: 9 · 2017: 11 · 2016: 4 · 2015: 4
- FWCI
- 14.06
- Type
- journal article
- Language
- en
- Open access
- green
- pure.amsterdamumc.nl
- Licence
- Locations
- Depression and Anxiety (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion, other-oa)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
- KNAW research portal (Royal Academy of Art and Sciences (KNAW)) (publishedVersion)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- KNAW Research Portal (The Royal Netherlands Academy of Arts and Sciences) (submittedVersion)
- VU Research Portal (submittedVersion)
- Funders
- Netherlands Organisation for Health Research and Development (NWO-VIDI 017.106.370)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Keywords
- circadian rhythm, sleep disorders, depression, anxiety disorders, actigraphy, sleep latency, wake after sleep onset, middle-aged and older adults, Rotterdam Study
- MeSH terms
- Aged, Aged, 80 and over, Anxiety, Anxiety Disorders, Circadian Rhythm, Depression, Depressive Disorder, Female, Humans, Male, Middle Aged, Research Design, Sleep, Sleep Wake Disorders, Odds Ratio, Actigraphy
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