Exploring multifaceted mental resilience from the perspectives of sleep and circadian rhythm in healthy adults
Chen, C. X.; Wang, R.; Cheung, F. T. W.; Chan, N. Y.; Li, T. M. H.; Chan, J. W. Y.; Zhang, J.; Hou, W. K.; Yau, S. Y.; Liu, Y.; Lee, T. M. C.; Li, S. X.; Wing, Y. K.
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Background: Emerging evidence suggested the role of sleep and circadian rhythm in the development of mental resilience, but the association of an integrated analysis of objective sleep and circadian measures with multifaceted mental resilience in healthy adults has been underexplored. Objective: This study aims to explore the associations between multifaceted mental resilience and sleep and circadian rhythm in healthy adults. Methods: A total of 156 healthy adults (Age: Mean (SD): 29.54 (5.28) years; 60.9% female) underwent 14-day actigraphy, one night polysomnography (PSG) and dim light melatonin onset (DLMO) assessments. Resilience was operationalized as both a coping capacity and a positive mental health outcome in the context of accumulative adversity (life stressful events and childhood adversities). We first identified the covariance patterns between multiple sleep and circadian health domains (Sleep macro- and microstructures, dim light melatonin onset, rest activity pattern) and multifaceted mental resilience using partial least squares regression (PLSR), and followed by univariate analysis as complementary to illustrate the distribution trends of sleep and circadian rhythm parameters across integrative resilience score derived from principal component analysis (PCA). Findings: The PLSR model identified a modest but significant association of greater mental resilience with a sleep and circadian profile (Bootstrapping r = 0.15, 95%CI: 0.02-0.28), characterized by greater frontal-central slow waves activity in NREM sleep, greater frontal theta activity in REM sleep, lower occipital spectral power across fast and slow frequency bands in NREM and REM sleep, and probably earlier dim light melatonin onset timing. Conclusions: Sleep and circadian metrics, specifically frontal slow waves and REM theta activity, attenuated overall occipital spectral power during sleep, and earlier dim light melatonin onset time, represent quantifiable targets that may serve to improve resilience and stress-related mental health in adults. Longitudinal and interventional studies are needed to establish whether sleep interventions can be endorsed as evidence-based approaches for resilience enhancement. Clinical implications: Targeting sleep and circadian aspects may be an important approach to promote stress-related mental health.
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