Actigraphy for evaluation of mood disorders: A systematic review and meta-analysis

Background: Actigraphy has enabled consecutive observation of individual health conditions such as sleep or daily activity. This study aimed to examine the usefulness of actigraphy in evaluating depressive and/or bipolar disorder symptoms. Method: A systematic review and meta-analysis was conducted. We selected studies that used actigraphy to compare either patients vs. healthy controls, or pre- vs. post-treatment data from the same patient group. Common actigraphy measurements, namely daily activity and sleep-related data, were extracted and synthesized. Results: Thirty-eight studies (n = 3,758) were included in the analysis. Compared with healthy controls, depressive patients were less active (standardized mean difference; SMD =1.27, 95%CI = [0.97, 1.57], P < 0.001) and had longer wake after sleep onset (SMD = - 0.729, 95%CI = [ - 1.20, - 0.25], p = 0.003). Total sleep time (SMD = - 0.33, 95%CI = [ - 0.55, - 0.11], P = 0.004), sleep latency (SMD = - 0.22, 95%CI = [- 0.42, - 0.02], P = 0.032), and wake after sleep onset (SMD = - 0.22, 95%CI = [ - 0.39, - 0.04], P = 0.015) were longer in euthymic/remitted patients compared to healthy controls. In pre- and post-treatment comparisons, sleep latency (SMD = - 0.85, 95%CI = [ - 1.53, - 0.17], P = 0.015), wake after sleep onset (SMD = - 0.65, 95%CI = [ - 1.20, - 0.10], P = 0.022), and sleep efficiency (SMD = 0.77, 95%CI = [0.29, 1.24], P = 0.002) showed significant improvement. Limitation: The sample sizes for each outcome were small. The type of actigraphy devices and patients' illness severity differed across studies. It is possible that hospitalizations and medication influenced the outcomes. Conclusion: We found significant differences between healthy controls and mood disorders patients for some actigraphy-measured modalities. Specific measurement patterns characterizing each mood disorder/status were also found. Additional actigraphy data linked to severity and/or treatment could enhance the clinical utility of actigraphy.