Integrated Analysis of Circadian and Sleep Signatures in Depression and Schizophrenia Using Multi-Day Actigraphy

Sleep abnormalities and circadian rhythm disruptions are frequently observed in psychiatric disorders such as depression and schizophrenia. However, most previous studies have examined circadian rhythms and sleep separately, limiting understanding of how these processes interact within individuals. This study examined circadian and sleep characteristics in depression and schizophrenia compared with healthy controls using multi-day wrist actigraphy. Circadian rhythms were assessed using parametric and non-parametric measures of rest-activity patterns, and sleep metrics were derived using a validated actigraphy-based algorithm. Distinct patterns were observed across diagnostic groups. Schizophrenia showed widespread disruption in daily activity patterns, with altered timing and reduced rhythm strength. Sleep was longer but highly fragmented, with frequent awakenings despite increased time in bed. In contrast, depression showed more limited changes, mainly in activity timing and overall activity levels, while sleep and daily patterns remained closer to controls. A key finding was the identification of distinct circadian-sleep profiles for each condition, with global disruption in schizophrenia and more selective alterations in depression. These findings show that combining circadian and sleep measures provides a clearer understanding of psychiatric disorders and may support monitoring and targeted interventions based on daily behavioral rhythms.