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Manic patients and sleep management: the role of polysomnography in clinical practice

Published online by Cambridge University Press:  01 September 2022

F. Pacchioni ,
M.C. Cavallini ,
L. Fregna ,
A. Sarzetto ,
F. Attanasio ,
B. Barbini  and
C. Colombo
F. Pacchioni*
Affiliation:
Università Vita-Salute San Raffaele, Psychiatry, Milano, Italy
M.C. Cavallini
Affiliation:
IRCCS San Raffaele Scientific Institute, Psychiatry - Mood Disorders, Milano, Italy
L. Fregna
Affiliation:
IRCCS San Raffaele Scientific Institute, Psychiatry - Mood Disorders, Milano, Italy
A. Sarzetto
Affiliation:
Università Vita-Salute San Raffaele, Psychiatry, Milano, Italy
F. Attanasio
Affiliation:
Università Vita-Salute San Raffaele, Psychiatry, Milano, Italy
B. Barbini
Affiliation:
IRCCS San Raffaele Scientific Institute, Psychiatry - Mood Disorders, Milano, Italy
C. Colombo
Affiliation:
Università Vita-Salute San Raffaele, Psychiatry, Milano, Italy IRCCS San Raffaele Scientific Institute, Psychiatry - Mood Disorders, Milano, Italy
*
*Corresponding author.

Abstract

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Introduction

Sleep plays a key role in the pathogenesis and clinic of mood disorders. However, few studies have investigated electroencephalographic sleep parameters during the manic phases of Bipolar Disorder (BD).

Objectives

Sleep management is a priority objective in the treatment of the manic phases of BD and the polysomnographic investigation can be a valid tool both in the diagnostic phase and in monitoring clinical progress.

Methods

Twenty-one patients affected by BD, manic phase, were subjected to sleep monitoring via PSG in the acute phase (at the entrance to the ward) and in the resolution phase (near discharge). All participants were also clinically evaluated using Young Manic Rating Scale (YMRS) Pittsburgh Sleep Quality Index (PSQI), Morningness-eveningness Questionnaire (MEQ) at different timepoints.

Results

Over the hospitalization time frame there was an increase in quantity (Total Sleep Time) and an improvement in the quality and effectiveness of sleep (Sleep Efficiency). In addition, from the point of view of the EEG structure, clinical improvement was accompanied by an increase in the percentage of REM sleep.

Conclusions

Sleep monitoring by PSG can be a valuable tool in the clinical setting both in the diagnostic phase, “objectively” ascertaining the amount of sleep, and in the prognostic phase, identifying electroencephalographic characteristics that can predict the patient’s progress and response to drug therapy. The improvement in effectiveness and continuity of sleep and the change in its structure that accompanies the resolution of manic symptoms also testifies how the regularization of the sleep-wake rhythm is to be considered a priority in treating manic phases.

Disclosure

No significant relationships.

Keywords

Bipola DisorderPolysomnographymaniasleep
Type
Abstract
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S408
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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