Associations between circadian misalignment and telomere length in BD: an actigraphy study

Abstract

Background Life expectancy is significantly decreased in bipolar disorder (BD). This is associated with accelerated cellular aging which can be estimated by telomere length (TL). However, specific determinants of shorter TL in BD are under-explored. This study examines whether circadian misalignment (i.e. mismatch between preferred and actual phase of circadian activity rhythms) is associated with shorter TL in BD. Methods Euthymic individuals with BD (n = 101) undertook 21 consecutive days of actigraphy recording and completed the Composite Scale of Morningness (CSM) to assess phase preference for activities (chronotype). Polymerase chain reaction was used to measure TL in blood. Cluster analysis identified circadian aligned/misaligned subgroups as defined by preferred (CSM score) and actual phases of activity (actigraphically determined onset of active and inactive periods). We tested for any associations between TL and clusters, with adjustments for between-cluster differences in socio-demographic and illness factors. Results We identified three clusters: an "Aligned Morning" cluster (n = 31) with preferred and actual timing of activity in the morning, an "Aligned Evening" cluster (n = 37) with preferred and actual timing of activity in the evening and a "Misaligned" cluster (n = 32) with an evening chronotype, but an earlier objective onset of active periods. After adjustment for confounders, we found that TL was significantly associated with circadian misalignment and older age. Conclusions Circadian misalignment may partly explain shorter TL in BD and could contribute to accelerated aging in these individuals.

WITHDRAWN: Analysis of ATPase-6 mtDNA mutations and telomere length in patients with bipolar disorder

“…Telomere lengths and the acceleration of epigenetic aging were shown to be signi cantly correlated (Fries et al 2020). According to Spano et al (2022), telomere length was related considerably to older age (Spano et al 2022b).…”

Mendelian randomization and colocalization analyses reveal an association between short sleep duration or morning chronotype and altered leukocyte telomere length

“…Furthermore, the effect of delayed circadian rhythm on telomeres may be associated with inflammation increasing and disorder of cell circadian metabolism, ultimately leading to cell damage and accelerating cell aging 4 . Studies have also linked circadian rhythm disorders with mental health issues, such as bipolar disorder, which has been associated with shorter telomere length in patients 22 . Therefore, our study highlights the importance of maintaining a regular sleep–wake schedule and a morning-oriented lifestyle to promote healthy aging.…”

Lithium levels and lifestyle in patients with bipolar disorder: a new tool for self-management

“…Whereas the influence of weight on lithium levels has been the subject of previous research (Grandjean and Lithium 2009), the influence of diet, sleep (Spano et al 2022), and physical activity has been neglected. Sleep is one of the most important lifestyle factors in BD and its regularity is used as a therapeutic tool to improve prognosis (Morton et al 2022).…”