Inverse association between slow-wave sleep and low-grade inflammation in children and adolescents with major depressive disorder

Michael A Strumberger; Isabelle Häberling; Sophie Emery; Mona Albermann; Noemi Baumgartner; Catrina Pedrett; Salome Wild; Brigitte Contin-Waldvogel; Susanne Walitza; Gregor Berger; Klaus Schmeck; Christian Cajochen

doi:10.1016/j.sleep.2024.04.007

Inverse association between slow-wave sleep and low-grade inflammation in children and adolescents with major depressive disorder

Sleep Med. 2024 Apr 15:119:103-113. doi: 10.1016/j.sleep.2024.04.007. Online ahead of print.

Affiliations

¹ Research Department of Child and Adolescent Psychiatry, Psychiatric Hospital of the University of Basel, Wilhelm-Klein-Str. 27, 4002, Basel, Switzerland; Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Wilhelm-Klein-Str. 27, 4002, Basel, Switzerland; Psychiatric Services Lucerne, Lucerne, Switzerland.
² Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital, University of Zurich, Neumünsterallee 9, 8032, Zurich, Switzerland.
³ Psychiatry St. Gallen, 9500, Wil, Switzerland.
⁴ University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Graduate School for Health Sciences, University of Bern, Switzerland; Translational Research Center, University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
⁵ Child and Adolescent Psychiatric Services Baselland, 4410, Liestal, Switzerland.
⁶ Department of Clinical Research, Medical Faculty, University of Basel, Basel, Switzerland.
⁷ Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Wilhelm-Klein-Str. 27, 4002, Basel, Switzerland. Electronic address: Christian.Cajochen@upk.ch.

PMID: 38669833
DOI: 10.1016/j.sleep.2024.04.007

Abstract

Objective: To investigate the relationship between both self-reported and objective sleep variables and low-grade inflammation in children and adolescents with major depressive disorder (MDD) of moderate to severe symptom severity.

Methods: In this cross-sectional study, we examined twenty-nine children and adolescents diagnosed with MDD and twenty-nine healthy controls (HC). Following a one-week actigraphy assessment, comprehensive sleep evaluations were conducted, including a one-night sleep EEG measurement and self-reported sleep data. Plasma high-sensitivity C-reactive protein (hsCRP) was employed as a marker to assess low-grade inflammation.

Results: No significant difference in hsCRP levels was observed between participants with MDD and HC. Furthermore, after adjusting for sleep difficulties, hsCRP exhibited no correlation with the severity of depressive symptoms. In HC, levels of hsCRP were not linked to self-reported and objective sleep variables. In contrast, depressed participants showed a significant correlation between hsCRP levels and increased subjective insomnia severity (Insomnia Severity Index; r = 0.41, p < 0.05), increased time spent in the N2 sleep stage (r = 0.47, p < 0.01), and decreased time spent in slow-wave sleep (r = - 0.61, p < 0.001). Upon additional adjustments for body mass index, tobacco use and depression severity, only the inverse association between hsCRP and time spent in slow-wave sleep retained statistical significance. Moderation analysis indicated that group status (MDD vs. HC) significantly moderates the association between slow-wave sleep and hsCRP.

Conclusion: Our findings suggest that alterations in the architecture of slow-wave sleep may have a significant influence on modulating low-grade inflammatory processes in children and adolescents with MDD.

Keywords: Adolescence; C-reactive protein; Depression; Inflammation; Sleep disturbance; Slow-wave sleep.