Sleep Disturbance in Bipolar Disorder: Therapeutic Implications

Plante, David T.; Winkelman, John W.

doi:10.1176/appi.ajp.2008.08010077

Cited by 227 publications

(155 citation statements)

References 136 publications

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“…One exception to this involves pregnant women with a bipolar disorder or past or current psychosis, in whom sleep plays a crucial role in the prevention of postpartum psychosis. 36 …”

Section: Discussionmentioning

confidence: 99%

Perceived Sleep Quality Is Worse Than Objective Parameters of Sleep in Pregnant Women with a Mental Disorder

Ravesteyn

Tulen

Kamperman

et al. 2014

Journal of Clinical Sleep Medicine

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Objective: Disturbed sleep during pregnancy is associated with adverse obstetric outcomes and less mental well-being. In pregnant women with a mental disorder, who frequently suffer from sleep problems, it is unknown whether predominantly objective or subjective sleep quality is more affected. To clarify this, we compared objective and subjective parameters of sleep quality between patients and healthy controls during pregnancy. Methods: This observational study was embedded in an ongoing study among pregnant women with a mental disorder at the department of Psychiatry of Erasmus University Medical Center Rotterdam, the Netherlands. We compared 21 pregnant women with a confi rmed mental disorder with 33 healthy controls (gestational age, 23-29 weeks). To measure objective parameters of sleep quality, all participants continuously wore a wrist actigraph for 7 days and nights. Subjective sleep quality was retrospectively assessed using the Pittsburgh Sleep Quality Index (PSQI) and on a daily basis with the Subjective Sleep Quality-scale (SSQ). Differences in parameters of sleep between patients and controls were tested using a multivariate linear regression analysis adjusted for parity, gestational age, educational level, and employment status. Results: Objective parameters of sleep quality and subjective sleep quality as assessed by the PSQI did not differ signifi cantly between patients and controls. Daily sleep reports showed that, relative to controls, patients had a signifi cantly worse average SSQ-score (5.2 vs. 7.6, adjusted β = 0.12, 95%CI = 0.03-0.53, p < 0.01). Conclusions: Our exploratory study suggests that perceived sleep quality reported on a daily basis by pregnant women with a mental disorder is worse than the sleep quality as measured by wrist actigraphy.

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“…One exception to this involves pregnant women with a bipolar disorder or past or current psychosis, in whom sleep plays a crucial role in the prevention of postpartum psychosis. 36 …”

Section: Discussionmentioning

confidence: 99%

Perceived Sleep Quality Is Worse Than Objective Parameters of Sleep in Pregnant Women with a Mental Disorder

Ravesteyn

Tulen

Kamperman

et al. 2014

Journal of Clinical Sleep Medicine

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“…They are also more likely to report sleep disturbances, which have a serious impact on mood stability. 28 This association between comorbid anxiety disorders and mood stability points to the critical importance of taking anxiety into account as a key feature when treating these patients.…”

Section: Discussionmentioning

confidence: 99%

Comorbid Anxiety Disorders in Canadians with Bipolar Disorder: Clinical Characteristics and Service Use

et al. 2013

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Objective: To examine the impact of anxiety disorders comorbid to bipolar disorder (BD) in a large, nationally representative sample, to describe the sociodemographic and clinical profiles of Canadians living with BD and with or without comorbid anxiety disorders, to identify the characteristics uniquely associated with comorbid anxiety, and to examine treatment patterns. Method: We analyzed data from the Canadian Community Health Survey: Mental Health and Well-Being, conducted among 38 492 Canadians. People meeting the criteria for BD ( n = 808) were compared based on the presence or absence of an assessed anxiety disorder (that is, social phobia, panic disorder, and agoraphobia). Results: People with BD and a comorbid anxiety disorder fare worse in terms of BD relapses, suicidality, and sleep disturbance, and are more likely to be taking psychiatric medication. They have more impairment in their work and social functioning and rate their health and life satisfaction lower. Despite the greater severity, they are not receiving additional psychological treatment, they feel they are not receiving the treatment they need, and they report more barriers to treatment. Conclusions: This study confirms the critical impact of comorbid anxiety on the course of BD in a large, nationally representative sample and reveals that the psychological treatment needs of this population are not being met. Clinical and research implications are discussed.

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“…Nevertheless, significant sleep-BPD associations were also found in community (Oltmanns et al, 2014;Selby, 2013) and prison (Harty et al, 2010) Fifth, some studies concentrated on the effects of comorbid or past history of depression (Akiskal, Yerevanian, Davis, King, & Lemmi, 1985), or just controlled for depression symptoms (Oltmanns et al, 2014), rather than a full range of psychiatric disorders. Bipolar disorder and post-traumatic stress disorder, for example, have been associated with both BPD (Zimmerman & Mattia, 1999) and sleep disturbance (Kobayashi, Boarts, & Delahanty, 2007;Plante & Winkelman, 2008). Nevertheless, the majority of studies did exclude participants with other psychiatric disorders (e.g., psychotic disorder, bipolar disorder, substance abuse, PTSD) or controlled for other psychiatric symptoms, e.g., substance abuse, PTSD (Harty et al, 2010;Selby et al, 2013), adding support to the independence of observed associations between BPD and sleep disturbance.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

The sleep phenotype of Borderline Personality Disorder: A systematic review and meta-analysis

Winsper

Tang

Marwaha

et al. 2017

Neuroscience & Biobehavioral Reviews

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There were few significant differences between BPD and clinical (majority depressed) control groups. Conclusion:BPD is associated with comparable sleep disturbances to those observed in depression. These disturbances are not solely attributable to comorbid depression. Given growing evidence that sleep disturbance may exacerbate emotional dysregulation and suicide risk, treatments for BPD should explicitly address sleep problems. Future studies should utilise prospective designs to ascertain whether (and in which circumstances) sleep problems predate or follow the onset of the disorder.

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Sleep Disturbance in Bipolar Disorder: Therapeutic Implications

Cited by 227 publications

References 136 publications

Perceived Sleep Quality Is Worse Than Objective Parameters of Sleep in Pregnant Women with a Mental Disorder

Perceived Sleep Quality Is Worse Than Objective Parameters of Sleep in Pregnant Women with a Mental Disorder

Comorbid Anxiety Disorders in Canadians with Bipolar Disorder: Clinical Characteristics and Service Use

The sleep phenotype of Borderline Personality Disorder: A systematic review and meta-analysis

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