Sleep problems in bipolar disorders: more than just insomnia

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...

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Published inActa 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
LanguageEnglish
Published United States Blackwell Publishing Ltd 01.05.2016
John Wiley and Sons Inc
Subjects
Online AccessGet full text
ISSN0001-690X
1600-0447
1600-0447
DOI10.1111/acps.12523

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Abstract 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.
AbstractList 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.
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. 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. 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. 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.
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.OBJECTIVESleep 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.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.METHODA 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.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.RESULTSOver 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.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.CONCLUSIONWhilst 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.
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.
Author Steinan, M. K.
Morken, G.
Scott, J.
Lagerberg, T. V.
Vaaler, A. E.
Melle, I.
Andreassen, O. A.
AuthorAffiliation 1 Faculty of Medicine Department of Neuroscience Norwegian University of Science and Technology Trondheim Norway
3 Academic Psychiatry Institute of Neuroscience Newcastle University Newcastle UK
4 Centre for Affective Disorders Institute of Psychiatry London UK
6 NORMENT Institute of Clinical Medicine University of Oslo Oslo Norway
7 NORMENT Division of Mental Health and Addiction Oslo University Hospital Oslo Norway
5 NORMENT KG Jebsen Centre for Psychosis Research Oslo University Hospital Oslo Norway
2 Department of Psychiatry St. Olavs University Hospital Trondheim Norway
AuthorAffiliation_xml – name: 4 Centre for Affective Disorders Institute of Psychiatry London UK
– name: 5 NORMENT KG Jebsen Centre for Psychosis Research Oslo University Hospital Oslo Norway
– name: 2 Department of Psychiatry St. Olavs University Hospital Trondheim Norway
– name: 6 NORMENT Institute of Clinical Medicine University of Oslo Oslo Norway
– name: 3 Academic Psychiatry Institute of Neuroscience Newcastle University Newcastle UK
– name: 1 Faculty of Medicine Department of Neuroscience Norwegian University of Science and Technology Trondheim Norway
– name: 7 NORMENT Division of Mental Health and Addiction Oslo University Hospital Oslo Norway
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  fullname: Steinan, M. K.
  email: Mette K. Steinan, AFFU, Department of Research and Development, St Olavs University Hospital, P O Box 3008 Lade, 7441 Trondheim, Norway., mette.steinan@ntnu.no
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Issue 5
Keywords sleep
hypersomnia
bipolar I disorder
bipolar II disorder
insomnia
Language English
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2015 The Authors. Acta Psychiatrica Scandinavica Published by John Wiley & Sons Ltd.
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Harvey AG. Sleep and circadian rhythms in bipolar disorder: seeking synchrony, harmony, and regulation. Am J Psychiatry 2008;165:820-829.
Rocha PM, Neves FS, Correa H. Significant sleep disturbances in euthymic bipolar patients. Compr Psychiatry 2013;54:1003-1008.
Kaplan KA, Harvey AG. Behavioral treatment of insomnia in bipolar disorder. Am J Psychiatry 2013;170:716-720.
First M, Spitzer R, Gibbon M, Williams J. Structured clinical interview for DSM-IV-TR axis I disorders, research version. Patient edn. New York: Biometrics Research, New York State Psychiatric Institute; 2002.
Hickie IB, Naismith SL, Robillard R, Scott EM, Hermens DF. Manipulating the sleep-wake cycle and circadian rhythms to improve clinical management of major depression. BMC Med 2013;11:79.
Manber R, Blasey C, Arnow B et al. Assessing insomnia severity in depression: comparison of depression rating scales and sleep diaries. J Psychiatr Res 2005;39:481-488.
Kelly T, Douglas L, Denmark L, Brasuell G, Lieberman DZ. The high prevalence of obstructive sleep apnea among patients with bipolar disorders. J Affect Disord 2013;151:54-58.
Tsuno N, Besset A, Ritchie K. Sleep and depression. J Clin Psychiatry 2005;66:1254-1269.
Wichniak A, Wierzbicka A, Jernajczyk W. Sleep and antidepressant treatment. Curr Pharm Des 2012;18:5802-5817.
Rush AJ, Gullion CM, Basco MR, Jarrett RB, Trivedi MH. The Inventory of Depressive Symptomatology (IDS): psychometric properties. Psychol Med 1996;26:477-486.
Gruber J, Harvey AG, Wang PW et al. Sleep functioning in relation to mood, function, and quality of life at entry to the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). J Affect Disord 2009;114:41-49.
Sylvia LG, Dupuy JM, Ostacher MJ et al. Sleep disturbance in euthymic bipolar patients. J Psychopharmacol 2012;26:1108-1112.
Harvey AG, Talbot LS, Gershon A. Sleep disturbance in bipolar disorder across the lifespan. Clin Psychol 2009;16:256-277.
Kaplan KA, Gruber J, Eidelman P, Talbot LS, Harvey AG. Hypersomnia in inter-episode bipolar disorder: does it have prognostic significance? J Affect Disord 2011;132:438-444.
Hayes JF, Miles J, Walters K, King M, Osborn DP. A systematic review and meta-analysis of premature mortality in bipolar affective disorder. Acta Psychiatr Scand 2015;131:417-425.
Jackson A, Cavanagh J, Scott J. A systematic review of manic and depressive prodromes. J Affect Disord 2003;74:209-217.
Ketter TA, Miller S, Dell'osso B, Calabrese JR, Frye MA, Citrome L. Balancing benefits and harms of treatments for acute bipolar depression. J Affect Disord 2014;169(Suppl 1):S24-S33.
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Soehner AM, Kaplan KA, Harvey AG. Prevalence and clinical correlates of co-occurring insomnia and hypersomnia symptoms in depression. J Affect Disord 2014;167:93-97.
Steinan MK, Krane-Gartiser K, Langsrud K, Sand T, Kallestad H, Morken G. Cognitive behavioral therapy for insomnia in euthymic bipolar disorder: study protocol for a randomized controlled trial. Trials 2014;15:24.
Kaplan KA, Talbot LS, Gruber J, Harvey AG. Evaluating sleep in bipolar disorder: comparison between actigraphy, polysomnography, and sleep diary. Bipolar Disord 2012;14:870-879.
Boudebesse C, Geoffroy PA, Bellivier F et al. Correlations between objective and subjective sleep and circadian markers in remitted patients with bipolar disorder. Chronobiol Int 2014;31:698-704.
Steinan MK, Krane-Gartiser K, Morken G, Scott J Sleep Problems in Euthymic Bipolar Disorders: A Review of Clinical Studies. Curr Psychiatry Rev 2015;11:1-9.
Young RC, Biggs JT, Ziegler VE, Meyer DA. A rating scale for mania: reliability, validity and sensitivity. Br J Psychiatry 1978;133:429-435.
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Welmer AK, von Arbin M, Murray V, Holmqvist LW, Sommerfeld DK. Determinants of mobility and self-care in older people with stroke: importance of somatosensory and perceptual functions. Phys Ther 2007;87:1633-1641.
Scott J. Clinical parameters of circadian rhythms in affective disorders. Eur Neuropsychopharmacol 2011;21(Suppl 4):S671-S675.
Plante DT, Winkelman JW. Sleep disturbance in bipolar disorder: therapeutic implications. Am J Psychiatry 2008;165:830-843.
Morken G, Vaaler AE, Folden GE, Andreassen OA, Malt UF. Age at onset of first episode and time to treatment in in-patients with bipolar disorder. Br J Psychiatry 2009;194:559-560.
Eidelman P, Talbot LS, Gruber J, Harvey AG. Sleep, illness course, and concurrent symptoms in inter-episode bipolar disorder. J Behav Ther Exp Psychiatry 2010;41:145-149.
2013; 149
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28235881 - Evid Based Ment Health. 2017 May;20(2):59
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Snippet Objective Sleep problems in bipolar disorder (BD) are common, but reported rates vary from 10% to 80%, depending on definitions, methodologies and management...
Sleep problems in bipolar disorder (BD) are common, but reported rates vary from 10% to 80%, depending on definitions, methodologies and management of...
Objective Sleep problems in bipolar disorder (BD) are common, but reported rates vary from 10% to 80%, depending on definitions, methodologies and management...
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SourceType Open Access Repository
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StartPage 368
SubjectTerms 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
Title Sleep problems in bipolar disorders: more than just insomnia
URI https://api.istex.fr/ark:/67375/WNG-R3ZPDWM4-W/fulltext.pdf
https://onlinelibrary.wiley.com/doi/abs/10.1111%2Facps.12523
https://www.ncbi.nlm.nih.gov/pubmed/26590799
https://www.proquest.com/docview/1781249668
https://www.proquest.com/docview/1781543434
https://www.proquest.com/docview/1787970860
https://pubmed.ncbi.nlm.nih.gov/PMC5063196
Volume 133
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