Home parenteral nutrition, sleep patterns, and depressive symptoms: Secondary analysis of cross-sectional data

Background

Patients receiving home parenteral nutrition (HPN) are known to experience psychological distress and have profoundly disrupted sleep. The aim of this analysis was to examine the relationship between sleep patterns with depressive symptoms and HPN characteristics.

Methods

The study was a secondary analysis of cross-sectional data examining sleep patterns using subjective and objective measures. Sleep was assessed by surveys and 7-day actigraphy. The Patient Health Questionnaire-8 was used to evaluate depressive symptoms. Participants provided information on HPN. Spearman correlations were calculated between sleep measures with depressive symptoms and HPN characteristics. Correlations were further examined in multivariable linear regression models.

Results

Thirty-two adults (age = 53 years; 75% female; 94% White) were included. Lower sleep quality (r = 0.54–0.60; P < 0.001) and later sleep timing (r = −0.35; P = 0.049) were correlated with higher depressive symptoms. Sleep patterns were also correlated with several HPN characteristics (r = −0.47 to 0.51). In linear regression models, rate of infusion was associated with sleep duration (β = −0.004 [0.002] h; P = 0.046) in which each 100 mL/h was associated with 24-min shorter duration. Higher total energy was associated with lower sleep quality (β = 0.0004 [0.0002] log-unit; P = 0.042), and higher volume was associated with longer sleep onset latency (β = 0.0006 [0.0003] log-min; P = 0.049).

Conclusions

We provide evidence supporting the link between poor and later sleep with higher depressive symptoms and identify potentially modifiable infusion characteristics (notably, slower rate of infusion and lower total energy and volume) that, on further verification, may support sleep among those receiving HPN.