Mette Kvisten Steinan1, Gunnar Morken1, Trine V Lagerberg2, Ingrid Melle3, Ole A Andreassen4, Arne E Vaaler1, Jan Scott5. 1. Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology & Department of Psychiatry, St. Olavs University Hospital, Trondheim, Norway. 2. NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, Oslo, Norway. 3. NORMENT, Institute of Clinical Medicine, University of Oslo, & NORMENT Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway. 4. NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Norway. 5. Academic Psychiatry, Institute of Neuroscience, Newcastle University, Centre for Affective Disorders, Institute of Psychiatry, London, United Kingdom. Electronic address: jan.scott@newcastle.ac.uk.
Abstract
BACKGROUND: Theoretical models of Bipolar Disorder (BD) highlight that sleep disturbances may be a marker of underlying circadian dysregulation. However, few studies of sleep in BD have reported on the most prevalent circadian sleep abnormality, namely Delayed Sleep Phase (DSP). METHODS: A cross-sectional study of 404 adults with BD who met published clinical criteria for insomnia, hypersomnia or DSP, and who had previously participated in a study of sleep in BD using a comprehensive structured interview assessment. RESULTS: About 10% of BD cases with a sleep problem met criteria for a DSP profile. The DSP group was younger and had a higher mean Body Mass Index (BMI) than the other groups. Also, DSP cases were significantly more likely to be prescribed mood stabilizers and antidepressant than insomnia cases. An exploratory analysis of selected symptom item ratings indicated that DSP was significantly more likely to be associated with impaired energy and activity levels. LIMITATIONS: The cross-sectional design precludes examination of longitudinal changes. DSP is identified by sleep profile, not by diagnostic criteria or objective sleep records such as actigraphy. The study uses data from a previous study to identify and examine the DSP group. CONCLUSIONS: The DSP group identified in this study can be differentiated from hypersomnia and insomnia groups on the basis of clinical and demographic features. The association of DSP with younger age, higher BMI and impaired energy and activity also suggest that this clinical profile may be a good proxy for underlying circadian dysregulation.
BACKGROUND: Theoretical models of Bipolar Disorder (BD) highlight that sleep disturbances may be a marker of underlying circadian dysregulation. However, few studies of sleep in BD have reported on the most prevalent circadian sleep abnormality, namely Delayed Sleep Phase (DSP). METHODS: A cross-sectional study of 404 adults with BD who met published clinical criteria for insomnia, hypersomnia or DSP, and who had previously participated in a study of sleep in BD using a comprehensive structured interview assessment. RESULTS: About 10% of BD cases with a sleep problem met criteria for a DSP profile. The DSP group was younger and had a higher mean Body Mass Index (BMI) than the other groups. Also, DSP cases were significantly more likely to be prescribed mood stabilizers and antidepressant than insomnia cases. An exploratory analysis of selected symptom item ratings indicated that DSP was significantly more likely to be associated with impaired energy and activity levels. LIMITATIONS: The cross-sectional design precludes examination of longitudinal changes. DSP is identified by sleep profile, not by diagnostic criteria or objective sleep records such as actigraphy. The study uses data from a previous study to identify and examine the DSP group. CONCLUSIONS: The DSP group identified in this study can be differentiated from hypersomnia and insomnia groups on the basis of clinical and demographic features. The association of DSP with younger age, higher BMI and impaired energy and activity also suggest that this clinical profile may be a good proxy for underlying circadian dysregulation.
Authors: Celine C Corona; Man Zhang; Abhishek Wadhawan; Melanie L Daue; Maureen W Groer; Aline Dagdag; Christopher A Lowry; Andrew J Hoisington; Kathleen A Ryan; John W Stiller; Dietmar Fuchs; Braxton D Mitchell; Teodor T Postolache Journal: Pteridines Date: 2019-02-19 Impact factor: 0.581
Authors: Nahid Banihashemi; Rébecca Robillard; Jean Yang; Joanne S Carpenter; Daniel F Hermens; Sharon L Naismith; Zoe Terpening; Django White; Elizabeth M Scott; Ian B Hickie Journal: BMC Psychiatry Date: 2016-09-09 Impact factor: 3.630