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The association between sleep and cognitive abnormalities in bipolar disorder

Published online by Cambridge University Press:  16 January 2019

A. J. Bradley ,
K. N. Anderson ,
P. Gallagher  and
R. H. McAllister-Williams
A. J. Bradley
Affiliation:
Institute of Neuroscience, Newcastle University, Wolfson Research Centre, Campus for Aging and Vitality, Westgate Road, Newcastle Upon Tyne, NE4 5LP, UK Eli Lilly and Company Limited, Lilly House, Priestly Road, Basingstoke RG24 9NL, UK
K. N. Anderson
Affiliation:
Regional Sleep Service, Freeman Hospital, Freeman Road, High Heaton, Newcastle upon Tyne NE7 7DN, UK
P. Gallagher
Affiliation:
Institute of Neuroscience, Newcastle University, Wolfson Research Centre, Campus for Aging and Vitality, Westgate Road, Newcastle Upon Tyne, NE4 5LP, UK
R. H. McAllister-Williams*
Affiliation:
Institute of Neuroscience, Newcastle University, Wolfson Research Centre, Campus for Aging and Vitality, Westgate Road, Newcastle Upon Tyne, NE4 5LP, UK Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle, UK
*
Author for correspondence: R. H. McAllister-Williams, E-mail: hamish.mcallister-williams@ncl.ac.uk
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Abstract

Background

Bipolar disorder (BD) is associated with attentional and processing abnormalities. Such abnormalities are also seen in healthy subjects with sleep disruption. We hypothesised cognitive abnormalities in BD patients would be worse in those with objectively verified sleep abnormalities.

Methods

Forty-six BD patients and 42 controls had comprehensive sleep/circadian rhythm assessment over 21 days alongside mood questionnaires. Cognitive function was assessed with a range of tasks including Psychomotor Vigilance Test (PVT), Attention Network Task (ANT) and Digit Symbol Substitution Test (DSST). BD participants with normal and abnormal sleep were compared with age- and sex-matched controls.

Results

BD patients had longer response times and made more lapses (responses >500 ms) than controls on the PVT (both p < 0.001). However, patients with normal sleep patterns did not differ from controls while those with sleep abnormalities did (p < 0.001). An identical pattern of effects were seen with the ANT response times, with the abnormality in bipolar abnormal sleepers related to the executive attentional network. Similarly, patients made fewer correct responses on the DSST compared with the controls (p < 0.001). Bipolar normal sleepers did not differ while those with abnormal sleep did (p < 0.001). All these differences were seen in bipolar abnormal sleepers who were euthymic (p < 0.01) and across the main abnormal sleep phenotypes.

Conclusions

We confirm impairment in attention and processing speed in BD. Rather than sleep abnormalities exacerbating such dysfunction, the impairments were confined to bipolar abnormal sleepers, consistent with sleep disturbance being the main driver of cognitive dysfunction.

Keywords

Attentionbipolar disordercognitioncognitive dysfunctionpsychomotor processing speedsleepsleep disturbance
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 1 , January 2020 , pp. 125 - 132
Copyright
Copyright © Cambridge University Press 2019 

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