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Sleep and circadian rhythms in delayed sleep–wake phase disorder: phenotypic differences between patients with and without comorbid depression

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dc.contributor.authorReis, Cátia
dc.contributor.authorPilz, Luísa K.
dc.contributor.authorPaiva, Teresa
dc.contributor.authorHidalgo, Maria Paz
dc.contributor.authorWright, Kenneth P.
dc.date.accessioned2025-07-04T13:48:25Z
dc.date.available2025-07-04T13:48:25Z
dc.date.issued2025
dc.description© 2025 European Sleep Research Society.pt_PT
dc.description.abstractDelayed sleep-wake phase disorder involves chronic difficulty going to bed and waking up at conventional times and often co-occurs with depression. This study compared sleep and circadian rhythms between patients with delayed sleep-wake phase disorder with depression (DSWPD-D) and without (DSWPD-ND) comorbid depression. Clinical records of 162 patients with delayed sleep-wake phase disorder (70 DSWPD-D, 92 DSWPD-ND) were analysed, including a subset of 76 patients with circadian phase determined by the dim light melatonin onset. Variables assessed included sleep behaviour on work and free days, weekly sleep duration, social jet lag, chronotype, and phase relationships between dim light melatonin onset and sleep/wake times. Mean (SD) or median [Q1-Q3] values were compared using t-tests or Mann-Whitney. Patients with DSWPD-D showed longer sleep on workdays (DSWPD-D = 7.63 hr [1.70] versus DSWPD-ND = 6.20 hr [1.59]; p < 0.001), but not on free days. DSWPD-D also showed later sleep onset (DSWPD-D = 03:30 14;hours [02:49 hours-04:23 hours], DSWPD-ND = 02:53 hours [02:00 hours-03:41 hours]; p = 0.02) and wake times (DSWPD-D = 11:30 hours [09:30 hours-13:00 hours], DSWPD-ND = 08:45 hours [07:20 hours-11:00 hours]; p < 0.01) on workdays. Furthermore, DSWPD-D showed less social jet lag (DSWPD-D = 0.38 [0.00-1.75] versus DSWPD-ND = 2.17 [1.25-3.03]; p < 0.01), and reported higher anxiety symptoms (DSWPD-D = 71.4% versus DSWPD-ND = 45.8%; p = 0.03) and medication use (DSWPD-D = 75.0% versus DSWPD-ND = 43.8%; p = 0.01). DSWPD-D also showed wider dim light melatonin onset phase relationships with dim light melatonin onset-mid-sleep (DSWPD-D = -5.77 [1.32] versus DSWPD-ND = -4.86 [1.53]; p = 0.01) and dim light melatonin onset-waketime (DSWPD-D = -9.46 [1.82]; DSWPD-ND = -8.13 [2.08]; p = 0.01). Multivariable Poisson regression, adjusted for age and sex, showed more medication use, less social jet lag, and longer weekly sleep duration as significantly associated with DSWPD-D. These findings suggest potential biopsychosocial protective factors linked to depression in delayed sleep-wake phase disorder. Further research is required to confirm these phenotypic differences and their relevance to delayed sleep-wake phase disorder aetiology and treatment.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationJ Sleep Res. 2025 Aug;34(4):e14437pt_PT
dc.identifier.doi10.1111/jsr.14437pt_PT
dc.identifier.eissn1365-2869
dc.identifier.issn0962-1105
dc.identifier.urihttp://hdl.handle.net/10400.5/102031
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherWileypt_PT
dc.relation.publisherversionhttps://onlinelibrary.wiley.com/journal/13652869pt_PT
dc.subjectDepressionpt_PT
dc.subjectDim light melatonin onsetpt_PT
dc.subjectSleep durationpt_PT
dc.subjectSocial jet lagpt_PT
dc.subjectWorkdayspt_PT
dc.titleSleep and circadian rhythms in delayed sleep–wake phase disorder: phenotypic differences between patients with and without comorbid depressionpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.issue4pt_PT
oaire.citation.titleJournal of Sleep Researchpt_PT
oaire.citation.volume34pt_PT
person.familyNamePeixinho Reis
person.familyNamePaiva
person.givenNameCátia Cristina
person.givenNameMaria Teresa Aguiar dos Santos
person.identifier1465255
person.identifier.ciencia-idC817-4B30-902F
person.identifier.ciencia-id7B10-224A-DB1D
person.identifier.orcid0000-0001-6585-3993
person.identifier.orcid0000-0002-7937-7841
person.identifier.scopus-author-id7005950248
rcaap.rightsrestrictedAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication39014fe9-c831-4a22-ae3c-e464f35592cc
relation.isAuthorOfPublicationc720c5dd-a926-4737-938d-a90e782dd837
relation.isAuthorOfPublication.latestForDiscovery39014fe9-c831-4a22-ae3c-e464f35592cc

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