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Inverse association between slow-wave sleep and low-grade inflammation in children and adolescents with major
Michael A Strumberger1, Isabelle Häberling2, Sophie Emery2
1Research Department of Child and Adolescent Psychiatry, Psychiatric Hospital of the University of Basel, Wilhelm-Klein-Str. 27, 4002, Basel, Switzerland; Centre for Chronobiology, Psychiatric Hospital of the University of Basel, Wilhelm-Klein-Str. 27, 4002, Basel, Switzerland; Psychiatric Services Lucerne, Lucerne, Switzerland.
Insights
Children with major depressive disorder (MDD) show links between slow-wave sleep and inflammation. Specifically, reduced slow-wave sleep in depressed youth correlates with higher inflammation markers.
Area of Science:
- Neuroscience
- Psychiatry
- Sleep Medicine
Background:
- Major depressive disorder (MDD) in children and adolescents is associated with various physiological changes.
- Low-grade inflammation is increasingly recognized as a potential factor in the pathophysiology of MDD.
- Sleep disturbances are common in youth with MDD, but their relationship with inflammation requires further investigation.
Purpose of the Study:
- To examine the association between objective and self-reported sleep variables and low-grade inflammation in children and adolescents with moderate to severe MDD.
- To compare these associations between individuals with MDD and healthy controls (HC).
Main Methods:
- A cross-sectional study involving 29 children/adolescents with MDD and 29 HC.
- One-week actigraphy for objective sleep assessment.
- One-night sleep electroencephalography (EEG) and self-reported sleep questionnaires.
- Plasma high-sensitivity C-reactive protein (hsCRP) as a marker for low-grade inflammation.
Main Results:
- No significant difference in hsCRP levels between MDD and HC groups.
- In MDD participants, hsCRP correlated with increased subjective insomnia and altered sleep architecture (more N2 sleep, less slow-wave sleep).
- After adjustments, only the inverse association between hsCRP and slow-wave sleep remained significant, with group status moderating this relationship.
Conclusions:
- Alterations in slow-wave sleep architecture may play a role in modulating low-grade inflammatory processes in pediatric MDD.
- Slow-wave sleep disruption is a potential mechanism linking MDD and inflammation in youth.
Objective:
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.
Methods:
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.
Results:
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.
Conclusion:
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.
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