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

• Published in: Sleep medicine Vol. 119; pp. 103 - 113
• Main Authors: Strumberger, Michael A., Häberling, Isabelle, Emery, Sophie, Albermann, Mona, Baumgartner, Noemi, Pedrett, Catrina, Wild, Salome, Contin-Waldvogel, Brigitte, Walitza, Susanne, Berger, Gregor, Schmeck, Klaus, Cajochen, Christian
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.07.2024
• Subjects: Actigraphy; Adolescence; Adolescent; C-reactive protein; C-Reactive Protein - analysis; Child; Cross-Sectional Studies; Depression; Depressive Disorder, Major - blood; Depressive Disorder, Major - physiopathology; Electroencephalography; Female; Humans; Inflammation; Inflammation - blood; Male; Self Report; Severity of Illness Index; Sleep disturbance; Sleep Initiation and Maintenance Disorders - blood; Sleep Initiation and Maintenance Disorders - physiopathology; Sleep, Slow-Wave - physiology; Slow-wave sleep; Sleep disturbance; Adolescence; Depression; Inflammation; Slow-wave sleep; C-reactive protein
• ISSN: 1389-9457; 1878-5506
• DOI: 10.1016/j.sleep.2024.04.007

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. 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. 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. 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. •Evidence for a relationship between sleep and inflammation in adolescents with MDD.•Inverse association between C-reactive protein and slow-wave sleep in MDD patients.•In healthy controls, low-grade inflammation is not linked to self-reported and objective sleep.