Sleep disturbances and circadian CLOCK genes in borderline personality disorder

Fleischer, Monika; Schäfer, Michael K. E.; Coogan, Andrew N.; Häßler, Frank; Thome, Johannes

doi:10.1007/s00702-012-0860-5

Cited by 27 publications

(23 citation statements)

References 61 publications

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“…There is also tentative evidence to suggest that ongoing sleep problems can contribute to the chronicity of the disorder (Plante et al, 2013b). It should be noted, however, that associations between sleep disturbance and BPD are likely to be bidirectional, as a number of symptoms and behaviours (e.g., impulsivity, substance abuse, chaotic lifestyle) central to BPD are known to disrupt sleep patterns (Fleischer, Schäfer, Coogan, Häßler, & Thome, 2012;Winsper & Tang, 2014).…”

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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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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“…As such, questionnaire studies show that BPD patients have more sleep complaints, use more hypnotics, and report more nightmares and negative toned dreams [1][2][3][4]. Reviews of polysomnography studies highlight the presence of longer sleep latencies, a higher number of night awakenings, reduced rapid eye movement (REM) sleep latencies, longer REM sleep duration, and higher REM density in BPD adult patients compared to healthy controls (HCs) [5,6]. Since BPD patients show comparable sleep disturbances to patients with major depressive disorder, such as delayed sleep onset and reduced total sleep time [7][8][9][10], studies must examine sleep parameters when patients are free of mood symptoms in order to control for depression as a confounding factor [5].…”

Section: Introduction Contextmentioning

confidence: 99%

Sleep-Wake Patterns of Adolescents with Borderline Personality Disorder and Bipolar Disorder

Huỳnh

Guilé

Breton

2015

Child Psychiatry Hum Dev

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Sleep-wake patterns are rarely examined in adolescents with borderline personality disorder (BPD) or bipolar disorder (BD). Within a developmental perspective, this study explores the sleep-wake cycle of adolescents aged 12-17 years with BPD or BD and healthy controls (HC) during periods with and without entrainment by school/work schedules. Eighteen euthymic BPD, six euthymic BD, and 20 HC adolescents wore wrist actigraphy during nine consecutive days to assess sleep-wake patterns. During school/work days, BPD adolescents spent more time awake when they were in bed compared to HC and BD adolescents (p = 0.039). On schedule-free days, BPD and BD youths spent more time in bed compared to HC adolescents (p = 0.015). BPD adolescents woke up over 1 h later compared to HC (p = 0.003). Total sleep time was more variable between nights in BPD adolescents compared to the HC group (p = 0.031). Future research should explore if sleep-wake pattern disruptions are a cause or a consequence of BPD symptomatology in adolescents. Addressing sleep-wake pattern during clinical assessment and treatment of BPD adolescents may potentially reduce their symptoms; this therapeutic effect still needs to be evaluated.

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“…This is somewhat surprising considering the centrality of dysregulation to the development and symptom profile of this complex disorder (Crowell et al 2009; Fleischer et al 2012; Kaess et al 2014). Recent reviews report that sleep fragmentation, alterations in Slow Wave Sleep and REM sleep, and dysphoric dreaming are prevalent in adult BPD (Hafizi 2013; Simor and Horváth 2013).…”

mentioning

confidence: 99%

Sleep Problems in Childhood and Borderline Personality Disorder Symptoms in Early Adolescence

Lereya

Winsper

Tang

et al. 2016

J Abnorm Child Psychol

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Sleep disorders, such as insomnia and nightmares, are commonly associated with Borderline Personality Disorder (BPD) in adulthood. Whether nightmares and sleep-onset and maintenance problems predate BPD symptoms earlier in development is unknown. We addressed this gap in the literature using data from the Avon Longitudinal Study of Parents and Children (ALSPAC). Participants included 6050 adolescents (51.4 % female) who completed the UK Childhood Interview for DSM-IV BPD at 11 to 12 years of age. Nightmares and sleep onset and maintenance problems were prospectively assessed via mother report when children were 2.5, 3.5, 4.8 and 6.8 years of age. Psychopathological (i.e., emotional temperament; psychiatric diagnoses; and emotional and behavioural problems) and psychosocial (i.e., abuse, maladaptive parenting, and family adversity) confounders were assessed via mother report. In logistic regressions, persistent nightmares (i.e., regular nightmares at 3 or more time-points) were significantly associated with BPD symptoms following adjustment for sleep onset and maintenance problems and all confounders (Adjusted Odds Ratio = 1.62; 95 % Confidence Interval = 1.12 to 2.32). Persistent sleep onset and maintenance problems were not significantly associated with BPD symptoms. In path analysis controlling for all associations between confounders, persistent nightmares independently predicted BPD symptoms (Probit co-efficient [β] = 0.08, p = 0.013). Emotional and behavioural problems significantly mediated the association between nightmares and BPD (β =0.016, p < 0.001), while nightmares significantly mediated associations between emotional temperament (β = 0.001, p = 0.018), abuse (β = 0.015, p = 0.018), maladaptive parenting (β = 0.002, p = 0.021) and subsequent BPD. These findings tentatively support that childhood nightmares may potentially increase the risk of BPD symptoms in early adolescence via a number of aetiological pathways. If replicated, the current findings could have important implications for early intervention, and assist clinicians in the identification of children at risk of developing BPD.Electronic supplementary materialThe online version of this article (doi:10.1007/s10802-016-0158-4) contains supplementary material, which is available to authorized users.

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Sleep disturbances and circadian CLOCK genes in borderline personality disorder

Cited by 27 publications

References 61 publications

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

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

Sleep-Wake Patterns of Adolescents with Borderline Personality Disorder and Bipolar Disorder

Sleep Problems in Childhood and Borderline Personality Disorder Symptoms in Early Adolescence

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