Treatment resistant depression (TRD) service outpatient's experience of sleep, activity, and using a Fitbit wearable activity and sleep tracker.

Purpose: 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. [ABSTRACT FROM AUTHOR]