The interrelationship between sleep and depression: a secondary analysis of a randomized controlled trial on mind-body-spirit intervention

Assessment of the Level of Physical Activity and Mood in Students after a Year of Study in a Mixed Mode in the Conditions of Restrictions Resulting from the Pandemic

The COVID-19 pandemic has forced social isolation affecting all areas of life. It also affected the functioning of schools and universities. Many countries have introduced full or partial distance learning. The aim of the study was to assess the level of physical activity and student mood of the Faculty of Physiotherapy of the Academy of Physical Education in Wrocław (Poland) and students of the Faculty of Health of the ODISSE University in Brussels (Belgium) after a year of the study conducted in a mixed mode due to contact restrictions resulting from the COVID-19 pandemic and checking which of the analyzed factors increases the risk of depression to the greatest extent.

MATERIAL AND METHODS

297 students from the 2nd to 4th year of full-time studies took part in the observation. The academic year 2020/2021 was assessed. Physical activity was assessed using the Global Physical Activity Questionnaire (GPAQ) recommended for this type of analysis by WHO. The GPAQ questionnaire enables the assessment of activity performed at work, movement, and leisure time and assesses the time of sitting or resting in a supine position. The Beck Depression Inventory was used to assess mental health. The subjects also completed a questionnaire concerning selected somatic features and describing their living conditions in the previous year.

RESULTS

In the group of Polish students, classes conducted in a completely remote mode accounted for about 50%, while in the group of Belgian students, about 75%. In the described period, 19% of students from Poland and 22% of students from Belgium were infected with COVID-19. The median of the results of the Beck Depression Scale in both groups was lower than 12 points (7 points in the AWF group and 8 points in the ODISSE group, respectively). A detailed analysis showed that in both study groups, more than 30% of students received results showing a depressed mood. A total of 19% of the surveyed students of the University of Physical Education and 27% of the ODISSE students were characterized by a result indicating mild depression. The results of the GPAQ questionnaire show that the total physical activity, including work/study, recreation, and mobility was 16.5 h a week for students from Poland and 7.4 h a week for students from Belgium.

CONCLUSIONS

Both groups of subjects reached all the thresholds recommended by the WHO as a sufficient level of weekly physical activity. A group of students of the Faculty of Physiotherapy of the University of Physical Education in Wrocław was characterized by more than twice as high (statistically significant) level of weekly physical activity as compared to the group of participants from the ODISSE University in Brussels. In both study groups, more than 30% of students experienced a lowered mood of varying intensity. It is necessary to monitor the mental state of students and, in the event of obtaining control results at a similar level, to implement psychological assistance for willing participants.

The association of exposure to air pollution and depression in women; a cross-sectional study of a middle-income country

Air pollution exposure has been related with mental disorders, especially depression; however, the available evidence on these associations in Low and Middle-Income Countries (LMICs) is scarce. Therefore, we aimed to assess the relationship between particulate matter (PM) exposure and indicators of traffic with depressive symptoms in women of Sabzevar, Iran. This cross-sectional study was based on 741 women aged 15-45 years (adults) in 2019. The annual average of PM₁₀, PM_2.5 and PM₁ at home was estimated using land use regression (LUR) models. Street map of Sabzevar was used to calculate the indicators of traffic, i.e., the proximity to major roads and total street length buffers with 100, 300 and 500 m radii around the participants' homes. We used the Center for Epidemiological Studies- Depression (CESD-20) Scale in the general population to measure depression scores. Quasi-Poisson models and logistic regression were used to examine the association and odds ratios of exposure to air pollution and depression scores adjusted for relevant covariates. Exposure to PM₁₀, PM_2.5 and PM₁ and total street length in 100 m buffer were significantly associated with higher depression scores. In fully adjusted model, an interquartile range (IQR) increase in PM₁₀, PM_2.5 and PM₁ concentration as well as total street length in 100 m buffer was associated with 1.25 (95% CI:1.03, 1.52, P-value = 0.02), 1.16 (95% CI: 1.06, 1.26, P-value< 0.01), 1.16 (95% CI: 1.03, 1.29, P-Value = 0.01) and 1.15 (95% CI: 1.06, 1.25, P-value< 0.01) odds of clinical depression, respectively. For street length in 300 and 500 m buffers and proximity to major roads, no statistically significant increased risk of clinical depression were observed. Overall, our findings recommended that air pollution exposure has increased the risk of clinical depression in women.

Mindfulness-Based Movement Intervention to Improve Sleep Quality: A Meta-Analysis and Moderator Analysis of Randomized Clinical Trials

(1) Background: Given that the most effective dose, optimal type, and most beneficial population for improving sleep with mindfulness-based movement (MBM) remains unknown, we conducted a systematic review and meta-analysis with moderator analysis of randomized controlled trials (RCTs) to assess these effects. (2) Methods: Three electronic databases (PubMed, Web of Science, and EBSCO) were systematically searched for RCTs published through August 2021 for analysis. The risk of bias of the included studies was assessed with Review Manager 5.3, and the meta-analysis was performed in Stata 16.0. (3) Results: A meta-analysis of 61 RCTs with 2697 participants showed that MBM significantly improved sleep quality compared to controls (SMD = −0.794; 95% CI: −0.794 to −0.994, p < 0.001, I2 = 90.7%). Moderator analysis showed that a long-term MBM (SMD = −0.829; 95% CI: 0.945 to 0.712; p < 0.001) had a larger effect size on sleep than a short-term MBM (SMD = −0.714; 95% CI: 0.784 to 0.644; p < 0.001). Practicing at least twice per week (SMD = −0.793; 95% CI: −0.868 to −0.718; p < 0.001) was more effective compared to practicing once per week (SMD = −0.687; 95% CI: −0.804 to −0.570; p < 0.001). Studies with a total intervention time of more than 24 h also revealed better sleep quality improvement (SMD = −0.759; 95% CI: −0.865 to −0.653; p < 0.001). In addition, the healthy population and older adults gained more from MBM than the patients and younger adults. (4) Conclusions: MBM can effectively improve subjective sleep quality, and the optimal intervention dose of MBM can be utilized in future intervention studies to treat or improve sleep disturbance (MBM more than twice a week for more than three months, with a total intervention time of more than 24 h).

The Use of Spiritual and Religious Interventions for the Treatment for Insomnia: A Scoping Review

Insomnia is a common problem, affecting individuals' health and quality of life. Among several therapies used to treat this condition, spiritual interventions are suggested to have beneficial outcomes on sleep disturbances. Nevertheless, a systematic compilation of the evidence available is still needed in the literature in order to scientifically investigate the topic. To examine the most common spiritual interventions proposed to treat sleep disorders and to assess the scientific evidence of these interventions. This is a scoping literature review conducted by independent researchers on the following databases: PubMed, SCOPUS, Web of Science, Cochrane Library and OpenGrey. A boolean expression was used, and all studies published in the last 5 years investigating the role of spiritual or religious interventions on insomnia were included. From a total of 3257 articles retrieved in our search, ten studies were included in the final analysis. There is a wide array of techniques used to treat insomnia or the mental disorders associated with insomnia, such as mantra, yoga, mindfulness, praying/meditation, daily spiritual experiences, psycho-religious training and intervention. The included studies showed a positive influence of spiritual/religious interventions on insomnia directly and indirectly. However, there is a scarcity of clinical trials and most studies have small sample sizes and used only subjective measures, resulting in a low evidence. The results of the present review point to a promising role of spirituality and religion on better sleep outcomes, particularly in the improvement in insomnia. However, the heterogeneity and the quality of these studies suggest caution while interpreting these findings. More clinical trials are needed in this area to provide a recommendation of these methods in clinical practice.

Personality and Insomnia Symptoms in Older Adults: The Baltimore Longitudinal Study of Aging

STUDY OBJECTIVE

To examine associations of personality dimensions and facets with insomnia symptoms in a community sample of older adults.

METHODS

We studied 1,049 participants aged 60-97 years in the Baltimore Longitudinal Study of Aging. Personality was assessed by the Revised NEO Personality Inventory (NEO-PI-R), and insomnia symptom severity was measured by the Women's Health Initiative Insomnia Rating Scale (WHIIRS).

RESULTS

Adjusting for demographic characteristics, higher neuroticism, lower conscientiousness, and lower extraversion were associated with greater insomnia symptom severity. These associations remained significant for neuroticism and conscientiousness when further adjusting for depressive symptoms and comorbidities. Higher scores on neuroticism facets Anxiety, Angry Hostility, and Depression, and lower scores on conscientiousness facets Competence, Order, and Achievement-Striving and on agreeableness facet Altruism were associated with greater insomnia symptom severity in fully adjusted models. Results were similar among cognitively normal older adults (N=966), except higher scores on extraversion facets Warmth and Assertiveness associated with lower insomnia symptom severity, and agreeableness facet Altruism was unassociated.

CONCLUSION

Among older adults, insomnia symptoms appear partially related to personality, with persons higher in neuroticism experiencing greater insomnia symptom severity, and those higher in conscientiousness experiencing lower insomnia symptom severity. Exploring facets of the Big Five dimensions may provide additional insight regarding the etiology and resolution of sleep disturbance, and some of these associations may differ based on cognitive status. Future studies should investigate the hypothesis that sleep impairment mediates part of the association between specific personality traits and health-related outcomes.

The effectiveness of spiritual interventions in the workplace for work-related health outcomes: A systematic review and meta-analysis

AIM

To investigate the effectiveness of spiritual interventions in the workplace for different health outcomes through the use of a meta-analysis of randomized controlled trials.

BACKGROUND

Most studies including spirituality in the workplace investigated it at the organisational/business level, while giving a secondary value to the well-being and quality of life of the workers.

METHODS

Systematic review and meta-analysis carried out on the following databases: SCOPUS, PubMed and Web of Science. Spiritual interventions investigating work-related health outcomes were included. Then, meta-analyses were conducted.

RESULTS

From a total of 2,832 studies, 7 articles were included in the systematic review and 6 in the meta-analysis. Spiritual interventions, as compared to controls, improved the health outcomes of the workers (standard mean difference (SMD), -1.42; 95% CI, -1.98, -0.86; p < .001; I²  = 96%). Subanalyses revealed that yoga was an effective intervention and that stress was reduced by these interventions.

CONCLUSION

Spiritual interventions in the workplace seem to be effective in improving workers' health. Nevertheless, the high heterogeneity and limited number of studies may hinder more robust conclusions at the moment.

IMPLICATIONS FOR NURSING MANAGEMENT

The use of spiritual interventions should be considered in workplaces in order to reduce the stress and other negative outcomes.

Prevalence and predictors of post-traumatic stress symptoms and depressive symptoms among Bangladeshi students during COVID-19 mandatory home confinement: A nationwide cross-sectional survey

The COVID-19 pandemic has brought not only the risk of infection but also unbearable mental health difficulties with the concern of educational loss among students. This study explored the adverse impact of the COVID-19 outbreak on Bangladeshi students' mental health and detected potential influencing factors related to post-traumatic stress symptoms (PTSS) and depressive symptoms. Convenience sampling was applied to collect data via online survey from 3997 college and university students between 29th May and 22nd July 2020. PHQ-9 and IES scales were used to assess depressive symptoms and PTSS, respectively. Of all participants, 52.87% had depressive symptoms and 40.91% had PTSS. Severe educational disruption was a risk factor for depressive symptoms (AOR = 1.68; 95% CI: 1.37-2.06) and PTSS (AOR = 1.86; 95% CI: 1.51-2.29). COVID-19 like symptoms including fever, cough, breathing difficulty and fatigue showed a stronger association with higher IES and PHQ-9 scores than other symptoms (e.g., diarrhea, sore throat) (p ≤ 0.01). Fear of infection and death by COVID-19 were risk factors for PTSS and depressive symptoms (p ≤ 0.01). Recreational activity and regular physical exercise emerged as the most protective factors for depressive symptoms and PTSS. The mental health of students is significantly affected in this pandemic suggesting the need for adequate psychological support.

A study on sleep apnea in patients with abnormal sewda type of depression

Objective: To preliminarily investigate the clinical features and PSG in abnormal sewda-type depressive insomnia.

Methods: A total of 127 abnormal sewda-type depressive insomnia patients were evaluated with overnight PSG, and 32 normal participants were compared.

Results: Patients with abnormal sewda-type depressive insomnia were compared with the control group; the sleep symptoms showed a long incubation period of sleep, low sleep maintenance rate, low sleep efficiency and poor sleep quality as well as daytime dysfunction. At process and continuity of sleep: Total sleep time, sleep efficiency, sleep maintenance rate in abnormal sewda-type depressive insomnia group were shorter than the control group. Wake after sleep onset, and sleep latency were longer than the control group. At sleep structure: N1 ratio and N2 ratio in depressive insomnia group were longer than the control group, N3 ratio and REM sleep ratio shorter than the control group. At REM index: REM latency, REM cycles, and REM sleep time were shorter than the control group.

Conclusion: Insomnia symptoms in abnormal sewda-type depression comorbid insomnia patients were similar to the ordinary insomnia patients. The PSG characteristics had significant changes in sleep process, sleep structure and REM indicators. The severity of the abnormal sewda-type depression was closely related to REM indicators. Change of REM sleep characteristics may be the specificity, and these could be taken as reference in diagnosis and identification of abnormal sewda-type depressive insomnia.

Changes in sleep pattern and sleep quality during COVID-19 lockdown

INTRODUCTION

To mitigate the spread of the pandemic coronavirus infection (COVID-19), governments across the world have adopted "lockdowns" which have confined many individuals to their homes. This disrupts normal life routines, elements of which are important circadian cues. The pandemic is also associated with new stressors, altered roles, and uncertainties about health and economic security, which are also likely to affect sleep. The current study is an online survey of sleep experience, routines, physical activity, and symptoms of anxiety and depression, to study the alterations associated with the lockdown.

MATERIALS AND METHODS

The survey was conducted in early May 2020 using a questionnaire circulated through social media platforms. Questions related to demographic characteristics, current and previous sleep schedules, routine, and working patterns. Insomnia (Insomnia Severity Index - 4), Stress (Perceived Stress Scale - 4), anxiety and depressive symptoms (Patient Health Questionnaire - 4) and physical activity (International Physical Activities Questionnaire) were assessed using standardized instruments.

RESULTS

A total of 958 valid responses were received. Compared to the prelockdown period, there was a shift to a later bedtime and waking time, with a reduction in night-time sleep and an increase in day-time napping. These effects were visible across occupational groups, but mostly affected working individuals except health professionals. Sleep quality deteriorated across groups. Reductions in sleep duration were associated with depressive symptoms.

CONCLUSIONS

The COVID-19 lockdown is associated with changes in sleep schedule and in the quantity and quality of night-time sleep. Although these changes are associated with elevated rates of emotional symptoms, it is unclear from these cross-sectional results, whether sleep deterioration produces psychological distress, or vice versa.

Mental Health Problems during the COVID-19 Pandemics and the Mitigation Effects of Exercise: A Longitudinal Study of College Students in China

(1) Background: The novel coronavirus disease 2019 (COVID-19) is a global public health emergency that has caused worldwide concern. Vast resources have been allocated to control the pandemic and treat patients. However, little attention has been paid to the adverse impact on mental health or effective mitigation strategies to improve mental health. (2) Purpose: The aim of this study was to assess the adverse impact of the COVID-19 outbreak on Chinese college students’ mental health, understand the underlying mechanisms, and explore feasible mitigation strategies. (3) Methods: During the peak time of the COVID-19 outbreak in China, we conducted longitudinal surveys of sixty-six college students. Structured questionnaires collected information on demographics, physical activity, negative emotions, sleep quality, and aggressiveness level. A mixed-effect model was used to evaluate associations between variables, and the mediating effect of sleep quality was further explored. A generalized additive model was used to determine the dose-response relationships between the COVID-19 death count, physical activity, and negative emotions. (4) Results: The COVID-19 death count showed a direct negative impact on general sleep quality (β = 1.37, 95% confidence interval [95% CI]: 0.55, 2.19) and reduced aggressiveness (β = −6.57, 95% CI: −12.78, −0.36). In contrast, the COVID-19 death count imposed not a direct but an indirect impact on general negative emotions (indirect effect (IE) = 0.81, p = 0.012), stress (IE = 0.40, p < 0.001), and anxiety (IE = 0.27, p = 0.004) with sleep quality as a mediator. Moreover, physical activity directly alleviated general negative emotions (β = −0.12, 95% CI: −0.22, −0.01), and the maximal mitigation effect occurred when weekly physical activity was about 2500 METs. (5) Conclusions: (a) The severity of the COVID-19 outbreak has an indirect effect on negative emotions by affecting sleep quality. (b) A possible mitigation strategy for improving mental health includes taking suitable amounts of daily physical activity and sleeping well. (c) The COVID-19 outbreak has reduced people’s aggressiveness, probably by making people realize the fragility and preciousness of life.

Insomnia and depression: How much is the overlap?

BACKGROUND

Previous literature considers insomnia as one of the features, predictor, and also as a residual symptom of depression. However, chronic insomnia and major depressive disorder (MDD) have overlapping features making differentiation between two difficult.

MATERIALS AND METHODS

Forty subjects in each of the three categories-MDD, insomnia (I) and combined diagnoses (MDD-I) were recruited in this study after excluding potential confounders. Diagnosis of MDD was made following Diagnostic and Statistical Manual 5 edition (DSM-5), while the International Classification of sleep disorders 3 edition criteria of insomnia were used for diagnosing insomnia. The severity of insomnia and depression was assessed using the Insomnia Severity Index (ISI) and Patient Health Questionnaire-9 (PHQ-9), respectively. Fatigue was assessed using the Fatigue Severity Scale (FSS), which was translated in Hindi for this study. All subjects were also asked regarding effect of good sleep at night on daytime symptoms, especially on mood.

RESULTS

Subjects in MDD group were younger than the other two. Insomnia group was significantly different from the other two groups on most of the measures according to the DSM-5 criteria for MDD. MDD group had lesser frequencies of initial insomnia, middle insomnia, dissatisfaction with sleep and overall distress during the day. MDD-I group had a higher prevalence of daytime sleepiness and hyperactivity/impulsivity. PHQ-9 score was the lowest in the insomnia group. Despite statistically significantly different, ISI score was clinically comparable. The severity of fatigue was comparable across three groups. Contrary to the MDD group, subjects in insomnia and MDD-I group reported significant improvement in daytime symptoms after a good sleep for even one night.

CONCLUSION

There is considerable overlap of symptoms between insomnia and MDD. Subjects having insomnia report significant improvement in daytime and mood symptoms after good sleep, contrary to subjects with MDD.

Gratitude in infertility: a cross-sectional examination of dispositional gratitude in coping with infertility-related stress in women undergoing IVF

STUDY QUESTION

Do sense of meaning and acceptance mediate the relationships between gratitude and infertility-related stress among women undergoing IVF?

SUMMARY ANSWER

Among women undergoing IVF, the negative relationships between gratitude and infertility-related stress are explained by a general sense of meaningfulness and acceptance of life.

WHAT IS KNOWN ALREADY

Infertility experts increasingly call for a re-balancing of the deficit-based view of psychosocial adjustment in IVF, which has been heavily dominated by studies of risk factors and psychological distress. Attention has been given to strength-based perspectives that emphasize character strengths and personal growth. Gratitude has been found to be a potent protective factor in coping with life stressors; however, its salutary effects and protective processes for infertile women undergoing IVF are yet to be explored.

STUDY DESIGN, SIZE, DURATION

This study utilized baseline data of a randomized controlled trial for mind–body interventions with 357 Hong Kong Chinese women. Data collection was conducted between January 2015 and December 2017.

PARTICIPANTS/MATERIALS, SETTINGS, METHODS

Eligible women were approached by a research assistant immediately after their first medical consultation at an ART centre of a major university-affiliated hospital. Participants were asked to complete a battery of questionnaires, including the Gratitude Questionnaire-6, the Fertility Problem Inventory, and the Holistic Well-Being Scale. Mediation analyses were conducted with bootstrapped samples.

MAIN RESULTS AND THE ROLE OF CHANCE

Of the 494 women who were approached, 357 (72.3%) provided informed consent and participated in the study. Results show that gratitude was negatively associated with all infertility-related stress domains (rs = −0.19 to −0.36), and these relationships are mediated by acceptance and loss of sense of meaning. Further, the link between gratitude and relationship concerns is mediated by loss of sense of meaning in women with a definable cause of infertility (95% CI = [−0.31, −0.08]), but by acceptance among those with unexplained infertility (95% CI = [−0.33, −0.01]).

LIMITATIONS, REASONS FOR CAUTION

The cross-sectional nature of the study precluded inferences of causality. Self-selection and self-report biases could be present. Our findings may not be readily generalizable to women who do not intend to undergo psychosocial intervention for their infertility or ART.

WIDER IMPLICATIONS OF THE FINDINGS

Our findings support the salutary effects of gratitude in coping with IVF and highlight the role of unexplained infertility in the coping process. These findings offer preliminary support to the use of psychosocial interventions in promoting gratitude, acceptance, and meaning reconstruction for reducing infertility-related stress in women undergoing IVF.

STUDY FUNDING/COMPETING INTEREST(S)

This study was funded by the Hong Kong University Grant Council—General Research Fund (HKU27400414). All authors declare no competing interests.

TRIAL REGISTRATION NUMBER

HKUCTR-1984.

Gender differences in latent classes of sleep quality in community-dwelling adults based on the Pittsburgh sleep quality index

This study investigated the latent classes of sleep quality based on the Pittsburgh Sleep Quality index (PSQI) in Chinese adults, and analyzed whether these latent classes differed between men and women. A total of 982 adults (age: 18-59 years) participated in the questionnaire survey, and the PSQI was used to assess sleep quality. Two latent classes of sleep quality were found in men, and the cut-off value of PSQI for predicting the poor sleep quality group was 6. Four latent classes were found in women, which were named 'good sleep', 'daytime dysfunction', 'inadequate sleep', and 'poor sleep', respectively. In women, the optimal cut-off values of the PSQI for predicting the poor and good sleep quality groups were 9 and 6, respectively. Women who were not included in the 'poor sleep' group but had a score not less than 2 in the 'sleep duration' or 'daytime dysfunction' dimensions of PSQI were classified into the 'inadequate sleep' group or the 'daytime dysfunction' group. The findings may benefit the identification of sleep problems and assist in more effective alleviation of these issues.

Aloysia citriodora Palau (lemon verbena) for insomnia patients: A randomized, double-blind, placebo-controlled clinical trial of efficacy and safety

Aloysia citriodora (A. citriodora) has a long history of traditional use for sedation and treatment of insomnia in different societies. This study was carried out to assess the efficacy of A. citriodora in patients with insomnia. One hundred patients were randomly divided into two groups of A. citriodora (total essential oil 1.66 mg/10 ml and total amount of flavonoid in terms of quercetin 3.22 mg/10 ml of the syrup) and placebo. They were advised to use 10 cc of the syrups; an hour before the bedtime for a period of 4 weeks. Participants were assessed using Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) questionnaires at the baseline and then 2 and 4 weeks after the enrollment. Mean scores of global PSQI and its four components including sleep latency, habitual sleep efficiency, daytime dysfunction, and subjective sleep quality and also ISI score in the A. citriodora group improved significantly after 4 weeks of treatment when compared with the placebo group (p < 0.001, for all of them). Also, improvement of global score of PSQI and ISI was observed in the intervention group as compared with the placebo group, 2 weeks after the enrollment (p < 0.001). The results of this study showed that oral intake of A. citriodora can be suggested as a complementary treatment for patients with insomnia.

A psychometric investigation of the sleep, circadian rhythms, and mood (SCRAM) questionnaire

The sleep, circadian rhythms, and mood (SCRAM) questionnaire (Byrne, Bullock et al., 2017) was designed to concurrently measure individual differences in three clinically important functions: diurnal preference, sleep quality, and mood. The 15-item questionnaire consists of three 5-item scales named Morningness, Good Sleep, and Depressed Mood. The overarching aim of the current project was to investigate the validity and reliability of the questionnaire. Here, we report on associations investigated in three data sets. Study 1 (N = 70, 80% females) was used to examine the test-retest reliability of the questionnaire, finding strong test-retest reliability of the three scales over a 2-week period (r's ranging from 0.73 to 0.86). Study 2 (N = 183, 80% females) enabled us to examine the construct validity of the SCRAM scales against well-validated self-report measures of diurnal preference, sleep quality, and depression. Strong correlations were found between each SCRAM scale and their respective measure in bivariate analyses, and associations were robust after the inclusion of the remaining two SCRAM scales as predictors in regression analyses. Data from Study 3 (N = 42, 100% males) were used to measure the extent to which SCRAM scores correlated with objective measures of sleep-wake behavior using actigraphy. Morningness was found to be related to earlier sleep onset and offset times, and Good Sleep was related to higher sleep efficiency but to no other measures of sleep quality; Depressed Mood was not related to actigraphy measures. The findings provide provisional support for construct validity and reliability of the SCRAM questionnaire as a measure of diurnal preference, sleep quality, and depressed mood. Future research into the psychometrics of SCRAM should test the questionnaire's discriminant and predictive validity in clinical samples.