Association of Physical Activity and Sleep Metrics with Depression in People with Type 1 Diabetes

Objective: This study aimed to investigate the association of physical activity and sleep metrics, measured via wrist-worn accelerometers, with depression in people with type 1 diabetes. Patients and Methods: People with type 1 diabetes were recruited from the Dasman Diabetes Institute in Kuwait and were invited to wear a wrist-worn accelerometer device for 7 days. Mean physical activity (overall acceleration), inactivity, light activity, moderate activity, vigorous activity, the distribution of physical activity intensity (intensity gradient), sleep duration and sleep efficiency were quantified from the accelerometer data. The associations of these metrics with depression were investigated using multiple linear regression. Results: A total of 551 people with type 1 diabetes (age 33.1 (9.5) years) were included. Overall physical activity (B = − 0.09, CI = − 0.14 to – 0.04), moderate intensity activity (B = − 0.02, CI = − 0.02 to − 0.01), vigorous intensity activity (B = − 0.16, CI = − 0.27 to − 0.05), and the intensity gradient (B = − 2.11, CI = − 3.51 to − 0.72) were negatively associated with depression score (p < 0.01) and these associations remain significant even after adjustment for age, sex, diabetes duration, and BMI. However, sleep duration and efficiency were not associated with depression. After mutual adjustment overall physical activity (B = − 0.07, CI = − 0.12 to − 0.01), but not the intensity gradient (B = − 0.90, CI = − 2.47 to 0.68), remained associated with depression. Conclusion: Overall, moderate and vigorous physical activity, and the intensity gradient were associated with lower symptoms of depression. Overall physical activity, rather than the distribution of activity intensity, appears more important in depression. This information can help guide physical activity interventions to improve depression in people with type 1 diabetes. Keywords: type 1 diabetes, depression, physical activity, sedentary behaviors