Sleep problems in bipolar disorders: more than just insomnia

• Published in: Acta psychiatrica Scandinavica Vol. 133; no. 5; pp. 368 - 377
• Main Authors: Steinan, M. K., Scott, J., Lagerberg, T. V., Melle, I., Andreassen, O. A., Vaaler, A. E., Morken, G.
• Format: Journal Article
• Language: English
• Published: United States Blackwell Publishing Ltd 01.05.2016; John Wiley and Sons Inc
• Subjects: Adult; Bipolar disorder; Bipolar Disorder - epidemiology; bipolar I disorder; bipolar II disorder; Comorbidity; Cross-Sectional Studies; Disorders of Excessive Somnolence - epidemiology; Female; Humans; hypersomnia; Insomnia; Male; Middle Aged; Norway - epidemiology; Original; sleep; Sleep disorders; Sleep Initiation and Maintenance Disorders - epidemiology; sleep; hypersomnia; bipolar I disorder; bipolar II disorder; insomnia
• ISSN: 0001-690X; 1600-0447; 1600-0447
• DOI: 10.1111/acps.12523

Objective Sleep problems in bipolar disorder (BD) are common, but reported rates vary from 10% to 80%, depending on definitions, methodologies and management of potential confounding factors. This multicenter study seeks to address these issues and also compares BD cases with Hypersomnia as well as the more commonly investigated Insomnia and No Sleep Problem groups. Method A cross‐sectional comparison of sleep profiles in 563 BD I and II individuals who participated in a structured assessment of demographic, clinical, illness history and treatment variables. Results Over 40% cases met criteria for Insomnia and 29% for Hypersomnia. In univariate analysis, Insomnia was associated with BD II depression whilst Hypersomnia was associated with BD I depression or euthymia. After controlling for confounders and covariates, it was demonstrated that Hypersomnia cases were significantly more likely to be younger, have BD I and be prescribed antidepressants whilst Insomnia cases had longer illness durations and were more likely to be prescribed benzodiazepines and hypnotics. Conclusion Whilst Insomnia symptoms are common in BD, Hypersomnia is a significant, frequently underexplored problem. Detailed analyses of large representative clinical samples are critical to extending our knowledge of differences between subgroups defined by sleep profile.