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Evidence suggests a high prevalence of depression in subjects with Sleep-Wake Disorders, with impaired sleep being both a risk factor and a symptom of depression. However, depression currently remains for the most undiagnosed in this population, which can lead to a lack or delay in the treatment, and ultimately contribute to chronicity, recurrence of depression, and increase risk of suicide. Depression is characterized by alteration in sleep architecture and imbalanced autonomic nervous system function, and specific alteration may serve as biomarkers to identify ongoing depression in subjects with Sleep-Wake Disorders undergoing polysomnography. Thus, the aim of this study is to investigate differences in sleep architecture and autonomic modulation, measured by heart rate and heart rate variability throughout sleep stages, in subjects undergoing polysomnography in a sleep clinic. Methods A preliminary sample of forty subjects undergoing polysomnography was recruited in three different sleep clinics. The Patient Health Questionnaire–9 was administered to participants before the beginning of the sleep study. A cut-off of 10 was applied to identify subjects with possible current depression. The polysomnography recordings were processed with the MEBsleep software (Medibio Limited) which automatically calculats sleep architecture indices, and heart rate and heart rate variability parameters throughout sleep stages. The Mann-Whitney U test was used to investigate differences between the depressed and non-depressed groups. Results Possible current depression was found in fourteen subjects (35%). These Subjects had statistically significant higher heart rate (median depressed=78.01, median non-depressed=64.61, p=0.01) and lower Root Mean Square of the Successive Difference (RMSSD; median depressed=18.41 ms, median non-depressed=26.52 ms, p=0.02), number of pairs of successive NN intervals that differ by more than 50 ms (pNN50. Median depressed=1.62%; median non-depressed=5.64%; p=0.03), and High Frequency (absolute power) in REM (median depressed=104.17 ms2; median non-depressed=214.58 ms2; p=0.03) than those without depression. No significant differences resulted in the sleep architecture indices. Conclusion These results preliminary indicates a decreased parasympathetic activity in subjects with possible depression during REM, suggesting that heart rate and heart rate variability during sleep may be used as biomarkers to identify current depression in subjects undergoing polysomnography in sleep clinics. Support (if any):

751 Heart Rate and Heart Rate Variability During Sleep As Biomarkers for Depression