title: Ambulatory sleep-wake patterns and variability in young people with emerging mental disorders.
abstract: BACKGROUND
  The nature of sleep-wake abnormalities in individuals with mental disorders remains unclear. The present study aimed to examine the differences in objective ambulatory measures of the sleep-wake and activity cycles across young people with anxiety, mood or psychotic disorders.
  
  
  METHODS
  Participants underwent several days of actigraphy monitoring. We divided participants into 5 groups (control, anxiety disorder, unipolar depression, bipolar disorder, psychotic disorder) according to primary diagnosis.
  
  
  RESULTS
  We enrolled 342 participants aged 12-35 years in our study: 41 healthy controls, 56 with anxiety disorder, 135 with unipolar depression, 80 with bipolar disorder and 30 with psychotic disorders. Compared with the control group, sleep onset tended to occur later in the anxiety, depression and bipolar groups; sleep offset occurred later in all primary diagnosis groups; the sleep period was longer in the anxiety, bipolar and psychosis groups; total sleep time was longer in the psychosis group; and sleep efficiency was lower in the depression group, with a similar tendency for the anxiety and bipolar groups. Sleep parameters were significantly more variable in patient subgroups than in controls. Cosinor analysis revealed delayed circadian activity profiles in the anxiety and bipolar groups and abnormal circadian curve in the psychosis group.
  
  
  CONCLUSIONS
  Although statistical analyses controlled for age, the sample included individuals from preadolescence to adulthood. Most participants from the primary diagnosis subgroups were taking psychotropic medications, and a large proportion had other comorbid mental disorders.
  
  
  CONCLUSIONS
  Our findings suggest that delayed and disorganized sleep offset times are common in young patients with various mental disorders. However, other sleep-wake cycle disturbances appear to be more prominent in broad diagnostic categories.
authors.affiliation: Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Brain & Mind Research Institute, Camperdown NSW, Australia.
authors.forename: Rébecca
authors.initials: R
authors.lastname: Robillard
authors.affiliation: Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Brain & Mind Research Institute, Camperdown NSW, Australia.
authors.forename: Daniel F
authors.initials: DF
authors.lastname: Hermens
authors.affiliation: Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Brain & Mind Research Institute, Camperdown NSW, Australia.
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Naismith
authors.affiliation: Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Brain & Mind Research Institute, Camperdown NSW, Australia.
authors.forename: Django
authors.initials: D
authors.lastname: White
authors.affiliation: Concord Medical School, The University of Sydney, Concord Centre for Cardiometabolic Health in Psychosis, Hospital Road, Concord NSW, Australia.
authors.forename: Naomi L
authors.initials: NL
authors.lastname: Rogers
authors.affiliation: Concord Medical School, The University of Sydney, Concord Centre for Cardiometabolic Health in Psychosis, Hospital Road, Concord NSW, Australia.
authors.forename: Tony K C
authors.initials: TK
authors.lastname: Ip
authors.affiliation: Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Brain & Mind Research Institute, Camperdown NSW, Australia.
authors.forename: Sharon J
authors.initials: SJ
authors.lastname: Mullin
authors.affiliation: Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Brain & Mind Research Institute, Camperdown NSW, Australia.
authors.forename: Gail A
authors.initials: GA
authors.lastname: Alvares
authors.affiliation: Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Brain & Mind Research Institute, Camperdown NSW, Australia.
authors.forename: Adam J
authors.initials: AJ
authors.lastname: Guastella
authors.affiliation: Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Brain & Mind Research Institute, Camperdown NSW, Australia.
authors.forename: Kristie Leigh
authors.initials: KL
authors.lastname: Smith
authors.affiliation: Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Brain & Mind Research Institute, Camperdown NSW, Australia.
authors.forename: Ye
authors.initials: Y
authors.lastname: Rong
authors.affiliation: Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Brain & Mind Research Institute, Camperdown NSW, Australia.
authors.forename: Bradley
authors.initials: B
authors.lastname: Whitwell
authors.affiliation: Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Brain & Mind Research Institute, Camperdown NSW, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Southan
authors.affiliation: Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Brain & Mind Research Institute, Camperdown NSW, Australia.
authors.forename: Nick
authors.initials: N
authors.lastname: Glozier
authors.affiliation: Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Brain & Mind Research Institute, Camperdown NSW, Australia.
authors.forename: Elizabeth M
authors.initials: EM
authors.lastname: Scott
authors.affiliation: Clinical Research Unit, Brain & Mind Research Institute, University of Sydney, Brain & Mind Research Institute, Camperdown NSW, Australia.
authors.forename: Ian B
authors.initials: IB
authors.lastname: Hickie
mesh_terms: D056044:Actigraphy; D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000188:drug therapy / Q000503:physiopathology*; D001714:Bipolar Disorder / Q000188:drug therapy / Q000503:physiopathology*; D002648:Child; D002940:Circadian Rhythm / Q000502:physiology; D003866:Depressive Disorder / Q000188:drug therapy / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity / Q000502:physiology*; D011618:Psychotic Disorders / Q000188:drug therapy / Q000503:physiopathology*; D012890:Sleep / Q000502:physiology*; D014851:Wakefulness / Q000502:physiology; D055815:Young Adult