Delayed sleep-wake rhythm is associated with cognitive dysfunction, social dysfunction, and deteriorated quality of life in patients with major depressive disorder

Yoshikazu Takaesu; Yuta Kanda; Yu Nagahama; Ayano Shiroma; Miho Ishii; Tasuku Hashimoto; Koichiro Watanabe

doi:10.3389/fpsyt.2022.1022144

Delayed sleep-wake rhythm is associated with cognitive dysfunction, social dysfunction, and deteriorated quality of life in patients with major depressive disorder

Front Psychiatry. 2022 Nov 7:13:1022144. doi: 10.3389/fpsyt.2022.1022144. eCollection 2022.

Authors

Yoshikazu Takaesu^{1

2}, Yuta Kanda², Yu Nagahama¹, Ayano Shiroma¹, Miho Ishii², Tasuku Hashimoto^{3

4

5}, Koichiro Watanabe²

Affiliations

¹ Department of Neuropsychiatry, Graduate School of Medicine, University of the Ryukyus, Nishihara, Japan.
² Department of Neuropsychiatry, Kyorin University School of Medicine, Tokyo, Japan.
³ Department of Psychiatry, School of Medicine, International University of Health and Welfare, Narita, Japan.
⁴ Department of Psychiatry, Sodegaura Satsukidai Hospital, Sodegaura, Japan.
⁵ Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan.

Abstract

Background: The delayed sleep-wake phase is commonly observed in major depressive disorder (MDD) and thought to be associated with functional impairments. This study aimed to evaluate the relationship between the delayed sleep-wake phase, cognitive dysfunction, social dysfunction, and quality of life in patients with MDD.

Methods: This cross-sectional design included 33 outpatients with MDD. Objective sleep-wake rhythm was assessed by actigraphy. Functional impairments were evaluated by the Japanese version of the Brief Assessment of Cognition in Schizophrenia (BACS-J), World Health Organization Disability Assessment Schedule (WHO-DAS), and Euro QOL 5 dimensions (EQ5D).

Results: Actigraphic assessment of the delayed sleep-wake phase (midpoint of sleep) was significantly correlated with the composite score of the BACS-J (r = -0.489, p = 0.010), WHO-DAS score (r = 0.466, p = 0.014), and EQ5D score (r = 0.472, p = 0.013). No significant correlation was found between the other actigraphic sleep parameters (sleep latency, total sleep time, and sleep efficiency) and functional impairments.

Conclusion: Our study's results suggested that the delayed sleep-wake phase is associated with cognitive dysfunction, social dysfunction, and deteriorated quality of life in patients with MDD. Clinicians should pay attention to the sleep-wake rhythm in patients with MDD in clinical settings.

Keywords: circadian rhythm sleep-wake disorders; cognitive dysfunction; delayed sleep-wake rhythm; major depressive disorder; quality of life; social dysfunction.