Abnormal sleep duration associated with hastened depressive recurrence in bipolar disorder

Gershon, Anda; Do, Dennis; Satyanarayana, Satyanand; Shah, Saloni; Yuen, Laura D.; Hooshmand, Farnaz; Miller, Shefali; Wang, Po; Ketter, Terence A.

doi:10.1016/j.jad.2017.05.015

Cited by 29 publications

(19 citation statements)

References 47 publications

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“…The aim of this review was to summarize and discuss the recent researches on the relations between circadian rhythm dysfunction and BD (listed in Table ). Moreover, I discuss the clinical implication of circadian rhythm dysfunction on the clinical diagnosis and treatment of BD.…”

Section: Summary Of the Study Findingsmentioning

confidence: 99%

“…reported that changes in the sleep–wake cycle were likely to occur prior to mood changes during the clinical course of BD, which indicated that changes in the sleep–wake cycle may trigger relapse. A study with a 2‐year longitudinal design found that abnormal sleep duration in recovered patients may act as a risk indicator for hastened depressive recurrences . Another study reported that irregularity of a sleep–wake cycle in remitted patients could predict relapse .…”

Section: Significance Of Circadian Rhythm In the Clinical Course Of Bdmentioning

confidence: 99%

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Circadian rhythm in bipolar disorder: A review of the literature

Takaesu

2018

Psychiatry Clin Neurosci

158

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Sleep disturbances and circadian rhythm dysfunction have been widely demonstrated in patients with bipolar disorder (BD). Irregularity of the sleep-wake rhythm, eveningness chronotype, abnormality of melatonin secretion, vulnerability of clock genes, and the irregularity of social time cues have also been well-documented in BD. Circadian rhythm dysfunction is prominent in BD compared with that in major depressive disorders, implying that circadian rhythm dysfunction is a trait marker of BD. In the clinical course of BD, the circadian rhythm dysfunctions may act as predictors for the first onset of BD and the relapse of mood episodes. Treatments focusing on sleep disturbances and circadian rhythm dysfunction in combination with pharmacological, psychosocial, and chronobiological treatments are believed to be useful for relapse prevention. Further studies are therefore warranted to clarify the relation between circadian rhythm dysfunction and the pathophysiology of BD to develop treatment strategies for achieving recovery in BD patients.

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Section: Summary Of the Study Findingsmentioning

confidence: 99%

Section: Significance Of Circadian Rhythm In the Clinical Course Of Bdmentioning

confidence: 99%

Circadian rhythm in bipolar disorder: A review of the literature

Takaesu

2018

Psychiatry Clin Neurosci

158

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“…In bipolar disorder (BD) they may occur in 30-60% of patients, but reported rates vary from 10% to 80% depending on definition and management of potential confounding factors such as pharmacological treatments ( Steinan et al, 2016a;2016b ). Sleep disturbances have been increasingly recognized as important predictors of relapse in both major depressive disorder (MDD) and BD ( Bao et al, 2017;Bromberger et al, 2016;Craig et al, 2000;Gershon et al, 2017;Sakurai et al, 2017 ). Most descriptive studies on depressed or BD subjects with sleep alterations have focused on insomnia or decreased need to sleep, while fewer studies explored the presence of hypersomnia and its associated clinical features, despite its reported prevalence in 17-78% of patients with BD depression ( Steinan et al, 2016b ).…”

Section: Introductionmentioning

confidence: 99%

The implications of hypersomnia in the context of major depression: Results from a large, international, observational study

Murru

Guiso

Barbuti

et al. 2019

European Neuropsychopharmacology

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According to the DSM-5, "reduction in the need for sleep" is the only sleep-related criteria for mixed features in depressive episodes. We aimed at studying the prevalence, clinical correlates and the role of hypersomnia in a sample of acutely depressed patients. Secondarily, we factors significantly increasing the odds of hypersomnia were studied. We conducted a posthoc analysis of the BRIDGE-II-Mix study. Variables were compared between patients with hypersomnia (SLEEP +) and with insomnia (SLEEP −) with standard bivariate tests. A stepwise backward logistic regression model was performed with SLEEP + as dependent variable. A total of 2514 subjects were dichotomized into SLEEP + (n = 423, 16.8%) and SLEEP − (n = 2091, 83.2%). SLEEP + had significant higher rates of obese BMI (p < 0.001), BD diagnosis (p = 0.027), severe BD (p < 0.001), lifetime suicide attempts (p < 0.001), lower age at first depression (p = 0.004) than SLEEP −. Also, SLEEP + had significantly poorer response to antidepressants (AD) such as (hypo)manic switches, AD resistance, affective lability, or irritability (all 0 < 0.005). Moreover, SLEEP + had significantly higher rates of mixed-state specifiers than SLEEP-(all 0 < 0.006). A significant contribution to hypersomnia in our regression model was driven by metabolic-related features, such as "current bulimia" (OR = 4.21) and "overweight/obese BMI (OR = 1.42)". Globally, hypersomnia is associated with poor outcome in acute depression. Hypersomnia is strongly associated with mixed features and bipolarity. Metabolic aspects could influence the expression of hypersomnia, worsening the overall clinical outcome. Along with commonly used screening tools, detection of hypersomnia has potential, costless discriminative validity in the differential diagnosis unipolar and bipolar depression.

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“…Using a retrospective life chart approach, Kanady, Soehnera, and Harvey () found that manic months were associated primarily with reduced sleep need (62.8%) and insomnia (38.1%), months of predominantly depressive symptoms were characterized by hypersomnia (56.0%) and insomnia (51.9%), interepisode months were characterized primarily by insomnia (67.4%), and months of (highly dysregulated) mixed states were associated with multiple sleep problems. Hypersomnia during the euthymic phase of BD is receiving growing attention, because of its association with poor health outcomes generally and episode relapse specifically (Gershon et al, ; Kaplan, Gruber, Eidelman, Talbot, & Harvey, ): Preliminary work has identified two distinct subgroups of hypersomnia in BD—long bedrest duration and excessive sleepiness (Kaplan et al, ).…”

Section: Sleep Abnormalities In Bdmentioning

confidence: 99%

“…Research on the role of sleep disturbances has concentrated on the consequences of sleep deprivation; however, hypersomnia is also a common experience in BD (Steinan, Scott et al, ). Although less is known about the impacts of hypersomnia on BD relapses, there is emerging evidence that abnormal sleep duration is associated with next day depressive symptoms (Perlman et al, ) and hastened depressive recurrence (Gershon et al, ). This proposed relationship is also supported by evidence that hypersomnia may be a treatment target in bipolar depression: Sleep deprivation (typically combined with other chronobiological scaffolding to maintain therapeutic effects) may help ameliorate depressive symptoms in BD (Gottlieb et al, ; Suzuki et al, ).…”

Section: Predictive Role Of Sleep In Bdmentioning

confidence: 99%

Assessment and treatment of sleep problems in bipolar disorder—A guide for psychologists and clinically focused review

Morton

Murray

2020

Clin Psychology and Psychoth

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Sleep problems are highly prevalent in bipolar disorder (BD) and constitute an important therapeutic focus in this population: They are highly impairing and distressing, are an area of subjective importance to consumers, and likely play a role in predicting/triggering mood episodes. The aim of this review is to orient psychologists and psychotherapists to current research relevant to their clinical practice with people with BD, including (a) the prevalence and presentation of sleep problems, (b) the impacts and correlates of impaired sleep, and (c) the relationship between sleep problems and mood symptoms (including the predictive/triggering role of sleep in BD mood relapses). Detailed recommendations for assessment and cognitivebehavioural intervention strategies for use in BD are described. It will be concluded that although some sleep problems and comorbidities require interdisciplinary collaboration, a range of evidence-informed strategies can be effectively and appropriately applied by clinical psychologists and psychotherapists. K E Y W O R D Sbipolar disorder, circadian, mood disorder, psychiatric disorder, self-management, sleep

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Abnormal sleep duration associated with hastened depressive recurrence in bipolar disorder

Abstract: Baseline ASD among recovered BD patients may be a risk marker for hastened depressive recurrence, suggesting it could be an important therapeutic target between mood episodes.

Cited by 29 publications

References 47 publications

Circadian rhythm in bipolar disorder: A review of the literature

Circadian rhythm in bipolar disorder: A review of the literature

The implications of hypersomnia in the context of major depression: Results from a large, international, observational study

Assessment and treatment of sleep problems in bipolar disorder—A guide for psychologists and clinically focused review

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