The real-world association between digital markers of circadian disruption and mental health risks
Open accessAbstract
While circadian disruption is recognized as a potential driver of depression, its real-world impact is poorly understood. A critical step to addressing this is the noninvasive collection of physiological time-series data outside laboratory settings in large populations. Digital tools offer promise in this endeavor. Here, using wearable data, we first quantify the degrees of circadian disruption, both between different internal rhythms and between each internal rhythm and the sleep-wake cycle. Our analysis, based on over 50,000 days of data from over 800 first-year training physicians, reveals bidirectional links between digital markers of circadian disruption and mood both before and after they began shift work, while accounting for confounders such as demographic and geographic variables. We further validate this by finding clinically relevant changes in the 9-item Patient Health Questionnaire score. Our findings validate a scalable digital measure of circadian disruption that could serve as a marker for psychiatric intervention.
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There have been major innovations in the estimation of circadian parameters in real‐world settings via application of mathematical models to wearables.
“there have been major innovations in the estimation of circadian parameters in real‐world settings via application of mathematical models to wearables [58, 59].”
From Essential Information About Chronobiology and Chronotherapy for the Optimal Care of People With Bipolar Disorders: An Expert Consensus (2026) · cites this paper as [58]
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References 89 · Cited by 29
Research works printed but not linked: 6
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- Authors
- Lee, M. P., Kim, D. W., Fang, Y., Kim, R., Bohnert, A. S. B., Sen, S., & Forger, D. B.
- Affiliations
- University of Michigan (US)
- Sogang University (KR)
- Corresponding author
- Kim, Dae Wook
- Forger, Daniel B.
- Venue
- npj Digital Medicine
- Published
- 2024-12-05
- Volume
- 7
- Issue
- 1
- Pages
- 355-355
- ISSN
- 2398-6352 (ISSN-L)
- PMC
- PMC11621392
- OpenAlex
- W4405077784
- Cited by
- 29
- References
- 89
- Citations by year
- 2026: 12 · 2025: 17
- FWCI
- 6.24
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- npj Digital Medicine (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- National Science Foundation (2052499)
- National Institutes of Health
- Multidisciplinary University Research Initiative
- Army Research Office (W911NF)
- Topics
- Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Keywords
- circadian rhythm disruption, digital markers, wearable devices, shift work, depression, mood, sleep-wake cycle, internal rhythm, Patient Health Questionnaire, mental health, real-world data
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