Chronobiology, sleep-related risk factors and light therapy in perinatal depression: the "Life-ON" project.
BACKGROUND
Perinatal depression (PND) has an overall estimated prevalence of roughly 12 %. Untreated PND has significant negative consequences not only on the health of the mothers, but also on the physical, emotional and cognitive development of their children. No certain risk factors are known to predict PND and no completely safe drug treatments are available during pregnancy and breastfeeding. Sleep and depression are strongly related to each other because of a solid reciprocal causal relationship. Bright light therapy (BLT) is a well-tested and safe treatment, effective in both depression and circadian/sleep disorders.


METHODS
In a 3-year longitudinal, observational, multicentre study, about 500 women will be recruited and followed-up from early pregnancy (10-15 gestational week) until 12 months after delivery. The primary aim of the present study is to systematically explore and characterize risk factors for PND by prospective sleep assessment (using wrist actigraphy, polysomnography and various sleep questionnaires) and bloodbased analysis of potential markers during the perinatal period (Life-ON study). Secondary aims are to explore the relationship between specific genetic polymorphisms and PND (substudy Life-ON1), to investigate the effectiveness of BLT in treating PND (substudy Life-ON2) and to test whether a short term trial of BLT during pregnancy can prevent PND (substudy Life-ON3).


CONCLUSIONS
The characterization of specific predictive and risk factors for PND may substantially contribute to improve preventive medical and social strategies for the affected women. The study results are expected to promote a better understanding of the relationship between sleep disorders and the development of PND and to confirm, in a large sample of women, the safety and efficacy of BLT both in prevention and treatment of PND.


BACKGROUND
ClinicalTrials.gov NCT02664467 . Registered 13 January 2016.
Department of Head, Neck and Sensory System, Neurology Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Simone
S
Baiardi
Department of Head, Neck and Sensory System, Neurology Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Fabio
F
Cirignotta
Sleep Medicine Center, Neuroscience Department, AOU Città della Salute e della Scienza - Molinette, Università di Torino, Torino, Italy.
Alessandro
A
Cicolin
Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital, Lugano, Switzerland.|Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Basel, Switzerland.|Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland.
Corrado
C
Garbazza
Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.
Armando
A
D'Agostino
Department of Health Sciences, Università degli Studi di Milano, Milan, Italy.
Orsola
O
Gambini
Sleep Medicine Center, Neuroscience Department, AOU Città della Salute e della Scienza - Molinette, Università di Torino, Torino, Italy.
Alessandra
A
Giordano
Sleep Medicine Center, San Paolo Hospital, Milan, Italy.
Mariapaola
M
Canevini
Sleep Medicine Center, San Paolo Hospital, Milan, Italy.
Elena
E
Zambrelli
Department of Obstetrics and Gynaecology, DMSD San Paolo, University of Milan, Milan, Italy.
Anna Maria
AM
Marconi
Department of Head, Neck and Sensory System, Neurology Unit, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Susanna
S
Mondini
Division of Neuropsychiatry and Brain Imaging, Department of Psychiatry (UPK), Psychiatric University Clinics Basel, University of Basel, Basel, Switzerland.
Stefan
S
Borgwardt
Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Basel, Switzerland.|Transfaculty Research Platform Molecular and Cognitive Neurosciences, University of Basel, Basel, Switzerland.
Christian
C
Cajochen
Department of Obstetrics and Gynecology, Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy.
Nicola
N
Rizzo
Sleep and Epilepsy Center, Neurocenter of Southern Switzerland, Civic Hospital, Lugano, Switzerland. mauro.manconi@eoc.ch.
Mauro
M
Manconi
D056044:Actigraphy; D000293:Adolescent; D000328:Adult; D003863:Depression / Q000523:psychology / Q000628:therapy*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009035:Mothers / Q000523:psychology; D010789:Phototherapy / Q000379:methods*; D017286:Polysomnography; D011247:Pregnancy; D011248:Pregnancy Complications / Q000523:psychology / Q000628:therapy*; D011446:Prospective Studies; D012307:Risk Factors; D012890:Sleep; D020178:Sleep Disorders, Circadian Rhythm / Q000523:psychology / Q000628:therapy*; D011795:Surveys and Questionnaires; D055815:Young Adult
Actigraphy; Chronobiology; Circadian rhythms; Light therapy; Perinatal depression; Polysomnography; Pregnancy; Sleep; Sleep disorders