Monisha RAVI, Dhamodhini K S, Maheshkumar KUPPUSAMY, Suvarna KANTIPUDI, Santhi SILAMBANAN, Padmavathi RAMASWAMY
Gulhane Medical Journal - 2026;68(2):132-137
Aims: Long-term stress is a contributing factor to the development of major depressive disorder. Persistent stress can lead to sleep disturbances, which in turn, sustain sympathetic nervous system activation and elevate cortisol levels. Stress, poor sleep quality, and depression adversely affect mental and physical health, leading to increased morbidity and mortality. This study aims to assess stress levels, sleep quality, and heart rate variability (HRV) among individuals with depressive symptoms. Methods: This cross-sectional study enrolled 80 participants (mean age of 23.4+/-5.57 years) comprising 40 individiuals diagnosed with the symptoms of depression by a psychiatrist and 40 healthy controls. Stress levels, sleep quality, depression levels, and cardiac autonomic function were measured using the Perceived Stress Scale (PSS), the Pittsburgh Quality of Sleep Index (PSQI), the Patient Health Questionnaire-9 (PHQ-9) and the Hamilton Depression Rating Scale (HAM-D) for depression, and HRV analysis for cardiac autonomic function. Results: Participants with depressive symptoms demonstrated significantly poorer HRV parameters compared to healthy controls (p<0.05), as indicated by lower root mean square of successive differences (31.74+/-18.74 vs. 44.57+/-23.79), higher low frequency (LF) power in normalized units (LF nu: 70.57+/-12.45 vs. 42.69+/-11.96), and lower high frequency (HF) power in normalized units (HF nu: 29.48+/-11.57 vs. 55.39+/-11.45). Depression severity was significantly higher in patients with depression compared to healthy participants including PHQ-9 scores (9.90+/-3.84 vs. 1.98+/-1.33) and HAM-D scores (12.05+/-2.83 vs. 4.10+/-1.68) (p<0.001). Additionally, patients with depression exhibited significantly elevated PSS scores (27.42+/-3.21 vs. 13.35+/-2.68) and PSQI scores (8.62+/-2.12 vs. 3.67+/-1.67), indicating higher stress levels and poorer sleep quality (p<0.001). Conclusions: Individuals with depressive symptoms exhibited significantly lower HRV parameters, higher perceived stress levels, and poorer sleep quality compared to healthy controls. The findings suggest that depression is associated with altered autonomic function and increased stress perception. These results highlight the importance of monitoring HRV, stress, and sleep quality as potential biomarkers for depression severity and treatment response.
