MedWire News: Adolescents with bipolar disorder (BD) have distinct patterns of poor sleep quality, with longer sleep onset latency and an increased number of nighttime awakenings compared with their mentally healthy counterparts, study results show.
"Sleep disturbance may be [an] early marker for the onset and progression of BD in youth at familial risk for BD, with continued sleep disturbance contributing to relapse," write Manpreet Singh (Stanford University, California, USA) and team in the journal Child Psychiatry and Human Development.
The researchers compared sleep quality in 27 adolescents, aged 13-18 years, with type I BD who had experienced a manic episode within the previous 12 months and 24 mentally healthy controlsof similar age, ethnicity, and gender distribution.
All of the participants, as well as their parents, completed a sleep questionnaire based on the Pittsburgh Sleep Quality Index, which measures sleep variables during the past week, including total sleep time, number of nighttime awakenings, total time awake during awakenings, and sleep onset latency.
Mood symptoms in participants with BD were assessed using the Young Mania Rating Scale and the Childhood Depression Rating Scale.
Results from the self-report questionnaire revealed that, during weekdays, participants with BD had significantly longer mean sleep onset latency, more frequent nighttime awakenings, and increased total time awake compared with controls, at 35.6 versus 20.7 minutes, 0.75 versus 0.52 awakenings, and 26.0 versus 1.9 minutes, respectively.
Furthermore, although parental reports of their offspring's sleep onset latency, nighttime awakenings, and total time awake differed significantly from that of the adolescents, they still revealed increased measures in BD patients compared with controls, at 41.5 versus 18.1 minutes, 1.1 versus 0.4 awakenings, and 52.3 versus 11.4 minutes, respectively.
Longer periods of worsening evening mood, increasing levels of excessive/inappropriate guilt, and greater seriousness of non-suicidal self-injurious behavior were significantly associated with poorer sleep measures in patients with BD.
Singh and team conclude: "Results of this study indicate that, compared to demographically similar healthy controls, adolescents with bipolar I disorder are indeed characterized by distinct patterns of sleep disruption."
They add: "It will be important to determine whether interventions targeted toward specific domains of sleep dysfunction improve overall long-term outcome and prevent progression of BD into adulthood."
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