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Treatment resistant depression (TRD) service outpatient’s experience of sleep, activity, and using a Fitbit wearable activity and sleep trackerPurpose Depression, physical health, well-being, sleep and physical activity are interlinked. Healthy levels of physical activity and effective night-time sleep can reduce depressive symptoms. In the context of their lives and symptoms of depression, this paper aims to understand participants’ experiences of using a Fitbit, physical activity and sleep and the barriers and facilitators for healthy sleep and physical activity. Design/methodology/approach Qualitative methods were used to conduct interviews with 19 patients (4 male; 15 female) diagnosed with treatment-resistant depression undergoing transcranial magnetic stimulation (TMS) treatment for depression. Reflexive thematic analysis was used. Findings Healthy sleep and physical activity levels are interlinked and reduce depressive symptoms as well as improving well-being and physical health. A Fitbit is useful to enhance physical activity, self-awareness, motivation, healthier lifestyles and effective sleep. Barriers to healthy sleep and physical activity levels included depressive symptoms, environmental factors and anxieties. Facilitators for healthy sleep and physical activity levels included knowledge of the benefits, support from family and friends and applying sleep hygiene. Practical implications There is a need to provide interventions using wearable activity trackers that build on the links between increased physical activity, improved sleep, enhanced well-being, better physical health and lower depressive symptoms. Originality/value To the best of the authors’ knowledge, this is the first time that patients undergoing TMS have had their experiences of sleep, activity and using a Fitbit investigated and reported.
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An exploration of patient experience of sleep, physical activity, and exercise in early psychosisBackground Compared to the general population, people with experience of psychosis have poorer physical fitness, higher levels of sedation, lower levels of physical activity, more sleep problems, and higher incidence of insomnia. Methods Thirty-one early intervention psychosis (EIP) service patients took part in an eight-week intervention: provision of a Fitbit, Fitbit software apps, sleep and physical activity guidance, and three discussion sessions with clinicians. Fifteen participants consented to be interviewed, 9 males and 6 females, age range 19–51, average age 29. In-depth interviews investigating patient experiences of sleep and physical activity were conducted. Thematic analysis was employed. Results Patients using an EIP service experience particular issues, problems, and barriers to engaging in effective and healthy sleep and physical activity/exercise; these can have a negative effect on mental and physical health, wellbeing, recovery, and sociability. Patients used factors such as medication, social support, practical strategies, and motivation enhancement to overcome issues, problems, and barriers. Discussion Healthy effective sleep and physical activity/exercise is important to EIP service patients’ wellbeing and mental and physical health. EIP services should consider and assess sleep and physical activity/exercise issues, and promote healthy effective sleep and physical activity/exercise within recovery focused practice.
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Investigation of physical activity, sleep, and mental health recovery in treatment resistant depression (TRD) patients receiving repetitive transcranial magnetic stimulation (rTMS) treatmentBackground Repetitive transcranial magnetic stimulation (rTMS) is effective in treating depression; however, the effect on physical activity, sleep and recovery is unclear. This study investigated rTMS effect on physical activity and sleep through providing patients with a Fitbit and software apps; and reports the impact of rTMS on depression, anxiety and mental health recovery. Methods Study design was a pre and post data collection without a control, with twenty-four participants with treatment-resistant depression (TRD). Measures used were Fitbit activity and sleep data, and patient-rated Recovering Quality of Life (ReQoL-20), Patient Health Questionnaire (PHQ-9) and Generalised Anxiety Disorder (GAD-7). Results Response and remission rates were, respectively: 34.8% and 39% for PHQ-9; 34.8% and 47.8% for GAD-7. ReQoL-20 response and reliable improvement were 29.4% and 53%. PHQ-9, GAD-7 and ReQol-20 scores significantly improved, with large effect sizes. Analysis of Fitbit activity and sleep data yielded non-significant results. The Fitbit data machine learning model classified two levels of depression to 82% accuracy. Limitations rTMS treatment was open-label and adjunct to existing antidepressant medication. No control group. Female patients were overrepresented. Conclusions Improvements on the ReQoL-20 and aspects of sleep and activity indicate the positive impact of rTMS on the individual's real world functioning and quality of life. A wearable activity tracker can provide feedback to patients and clinicians on sleep, physical activity and depression levels. Further research could be undertaken through a sufficiently powered RCT comparing rTMS versus rTMS with use of a Fitbit, its software applications, and sleep and physical activity advice.