Using heart rate profiles during sleep as a biomarker of depression

• Published in: BMC psychiatry Vol. 19; no. 1; pp. 168 - 11
• Main Authors: Saad, Mysa, Ray, Laura B., Bujaki, Brad, Parvaresh, Amir, Palamarchuk, Iryna, De Koninck, Joseph, Douglass, Alan, Lee, Elliott K., Soucy, Louis J., Fogel, Stuart, Morin, Charles M., Bastien, Célyne, Merali, Zul, Robillard, Rébecca
• Format: Journal Article
• Language: English
• Published: London BioMed Central 07.06.2019; BioMed Central Ltd; Springer Nature B.V; BMC
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Analysis; Anxiety; Artificial intelligence; Automation; Autonomic nervous system; Biomarkers; Cardiovascular diseases; Comorbidity; Depression - diagnosis; Depression - physiopathology; Depression - psychology; Depression, Mental; Diagnosis; Electrocardiography - methods; Electroencephalography - methods; Female; Health aspects; Heart beat; Heart rate; Heart Rate - physiology; Heart rate variability; Humans; Learning algorithms; Machine Learning; Major depressive disorder; Male; Medicine; Medicine & Public Health; Mental depression; Middle Aged; Mood disorders; Mortality; Neuromodulation; Obesity; Polysomnography - methods; Psychiatry; Psychotherapy; Research Article; Retrospective Studies; Sleep; Sleep - physiology; Sleep apnea; Sleep disorders; Sleep Wake Disorders - diagnosis; Sleep Wake Disorders - physiopathology; Sleep Wake Disorders - psychology; Smoking; Weight control; Young Adult; Autonomic nervous system; Heart rate variability; Major depressive disorder
• ISSN: 1471-244X; 1471-244X
• DOI: 10.1186/s12888-019-2152-1

Background Abnormalities in heart rate during sleep linked to impaired neuro-cardiac modulation may provide new information about physiological sleep signatures of depression. This study assessed the validity of an algorithm using patterns of heart rate changes during sleep to discriminate between individuals with depression and healthy controls. Methods A heart rate profiling algorithm was modeled using machine-learning based on 1203 polysomnograms from individuals with depression referred to a sleep clinic for the assessment of sleep abnormalities, including insomnia, excessive daytime fatigue, and sleep-related breathing disturbances ( n  = 664) and mentally healthy controls ( n  = 529). The final algorithm was tested on a distinct sample ( n  = 174) to categorize each individual as depressed or not depressed. The resulting categorizations were compared to medical record diagnoses. Results The algorithm had an overall classification accuracy of 79.9% [sensitivity: 82.8, 95% CI (0.73–0.89), specificity: 77.0, 95% CI (0.67–0.85)]. The algorithm remained highly sensitive across subgroups stratified by age, sex, depression severity, comorbid psychiatric illness, cardiovascular disease, and smoking status. Conclusions Sleep-derived heart rate patterns could act as an objective biomarker of depression, at least when it co-occurs with sleep disturbances, and may serve as a complimentary objective diagnostic tool. These findings highlight the extent to which some autonomic functions are impaired in individuals with depression, which warrants further investigation about potential underlying mechanisms.