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Sleep and circadian rhythm disturbance in bipolar disorder

Published online by Cambridge University Press:  08 February 2017

A. J. Bradley ,
R. Webb-Mitchell ,
A. Hazu ,
N. Slater ,
B. Middleton ,
P. Gallagher ,
H. McAllister-Williams  and
K. N. Anderson
A. J. Bradley
Affiliation:
Institute of Neuroscience, Newcastle University, Wolfson Research Centre, Campus for Aging and Vitality, Newcastle Upon Tyne, UK Eli Lilly and Company Limited, Lilly House, Basingstoke, UK
R. Webb-Mitchell
Affiliation:
Institute of Neuroscience, Newcastle University, Wolfson Research Centre, Campus for Aging and Vitality, Newcastle Upon Tyne, UK
A. Hazu
Affiliation:
Institute of Neuroscience, Newcastle University, Wolfson Research Centre, Campus for Aging and Vitality, Newcastle Upon Tyne, UK
N. Slater
Affiliation:
Institute of Neuroscience, Newcastle University, Wolfson Research Centre, Campus for Aging and Vitality, Newcastle Upon Tyne, UK
B. Middleton
Affiliation:
Surrey Sleep Research Centre and Centre for Chronobiology, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
P. Gallagher
Affiliation:
Institute of Neuroscience, Newcastle University, Wolfson Research Centre, Campus for Aging and Vitality, Newcastle Upon Tyne, UK
H. McAllister-Williams
Affiliation:
Institute of Neuroscience, Newcastle University, Wolfson Research Centre, Campus for Aging and Vitality, Newcastle Upon Tyne, UK Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle, UK
K. N. Anderson*
Affiliation:
Regional Sleep Service, Freeman Hospital, High Heaton, Newcastle upon Tyne, UK
*
*Address for correspondence: Dr K. N. Anderson, Regional Sleep Service, Freeman Hospital, Freeman Road, High Heaton, Newcastle upon Tyne NE7 7DN, UK. (Email: kirstie.anderson@nuth.nhs.uk)
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Abstract

Background

Subjective reports of insomnia and hypersomnia are common in bipolar disorder (BD). It is unclear to what extent these relate to underlying circadian rhythm disturbance (CRD). In this study we aimed to objectively assess sleep and circadian rhythm in a cohort of patients with BD compared to matched controls.

Method

Forty-six patients with BD and 42 controls had comprehensive sleep/circadian rhythm assessment with respiratory sleep studies, prolonged accelerometry over 3 weeks, sleep questionnaires and diaries, melatonin levels, alongside mood, psychosocial functioning and quality of life (QoL) questionnaires.

Results

Twenty-three (50%) patients with BD had abnormal sleep, of whom 12 (52%) had CRD and 29% had obstructive sleep apnoea. Patients with abnormal sleep had lower 24-h melatonin secretion compared to controls and patients with normal sleep. Abnormal sleep/CRD in BD was associated with impaired functioning and worse QoL.

Conclusions

BD is associated with high rates of abnormal sleep and CRD. The association between these disorders, mood and functioning, and the direction of causality, warrants further investigation.

Keywords

Bipolarcircadian rhythmcognitionmelatoninsleep.
Type
Original Articles
Information
Psychological Medicine , Volume 47 , Issue 9 , July 2017 , pp. 1678 - 1689
Copyright
Copyright © Cambridge University Press 2017 

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