Mood and motor activity in euthymic bipolar disorder with sleep disturbance

Krane-Gartiser, Karoline; Steinan, Mette Kvisten; Langsrud, Knut; Vestvik, Vegard; Sand, Trond; Fasmer, Ole Bernt; Kallestad, Håvard; Morken, Gunnar

doi:10.1016/j.jad.2016.05.012

Cited by 23 publications

(15 citation statements)

References 61 publications

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“…Some of the factors related to the hospitalization, particularly medication, may have an important influence on the differences in activity patterns and could both explain or disguise true differences between subgroups. Finally, the actigraphy monitoring lasted for only 24 h, which undermines the generalizability of our findings and prevents assessment of day-to-day variations, which is another interesting phenomenon in mood disorders [ 12 ]. As we were aware of these limitations from the outset, we tried to focus on a small number of carefully selected parameters and to limit our statistical tests to the minimum required to ensure the pilot study offered a viable first step in exploring activity in inpatients with mood disorders.…”

Section: Discussionmentioning

confidence: 99%

“…The application of actigraphy to measure daytime activity as well as sleep patterns represents an important opportunity for research in mood disorders and for instance, it may help confirm or refute whether reduced motor activity is a more common feature of BD depression compared to UP (as suggested in some clinical studies) and/or whether the overall patterns of activity differ over 24 h (possibly underlying circadian disturbances) [ 8 , 9 ]. However, actigraphy studies of motor activity have usually been conducted in either UP or BD [ 5 , 10 – 12 ], with comparator groups usually comprised of healthy controls (for a review, see [ 6 ]). To date, few studies have compared UP and BD groups that were recruited at the same time and/or from the same setting [ 13 – 17 ].…”

Section: Introductionmentioning

confidence: 99%

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Variability of activity patterns across mood disorders and time of day

et al. 2017

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BackgroundFew actigraphy studies in mood disorders have simultaneously included unipolar (UP) and bipolar (BD) depression or BD mixed states as a separate subgroup from mania. This study compared objectively measured activity in UP, BD depression, mania and mixed states and examined if patterns differed according to time of day and/or diagnostic group.MethodsEighty -eight acutely admitted inpatients with mood disorders (52 UP; 18 mania; 12 BD depression; 6 mixed states) underwent 24 hours of actigraphy monitoring. Non-parametric analyses were used to compare median activity level over 24 h (counts per minute), two time series (64-min periods of continuous motor activity) in the morning and evening, and variability in activity across and within groups.ResultsThere was no between-group difference in 24-h median level of activity, but significant differences emerged between BD depression compared to mania in the active morning period, and between UP and mania and mixed states in the active evening period. Within-group analyses revealed that UP cases showed several significant changes between morning and evening activity, with fewer changes in the BD groups.ConclusionsMean activity over 24 hours has limited utility in differentiating UP and BD. In contrast, analysis of non-linear variability measures of activity at different times of day could help objectively distinguish between mood disorder subgroups.Trial registrationClinicalTrials.gov Identifier: NCT01415323, first registration July 6, 2011.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Variability of activity patterns across mood disorders and time of day

et al. 2017

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“…Over longer times, bipolar disorder is associated with higher intra-daily variability and lower inter-daily stability 26 . Bipolar patients hospitalized during either manic or depressive episodes have different activity patterns quantified using measures of variability 27 , and circadian rhythms are related to mood variation in outpatients with euthymic bipolar disorder 28 . A systematic review reported that patients with depression have a lower daytime activity and higher night-time activity than individuals without depression, and concluded that analytical methods need to be improved to extract all relevant features from actigraph data 18 .…”

Section: Introductionmentioning

confidence: 99%

Quantification of free-living activity patterns using accelerometry in adults with mental illness

Chapman

Roberts

Nguyen

et al. 2017

Sci Rep

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Physical activity is disrupted in many psychiatric disorders. Advances in everyday technologies – such as accelerometers in smart phones – opens exciting possibilities for non-intrusive acquisition of activity data. Successful exploitation of this opportunity requires the validation of analytical methods that can capture the full movement spectrum. The study aim was to demonstrate an analytical approach to characterise accelerometer-derived activity patterns. Here, we use statistical methods to characterize accelerometer-derived activity patterns from a heterogeneous sample of 99 community-based adults with mental illnesses. Diagnoses were screened using the Mini International Neuropsychiatric Interview, and participants wore accelerometers for one week. We studied the relative ability of simple (exponential), complex (heavy-tailed), and composite models to explain patterns of activity and inactivity. Activity during wakefulness was a composite of brief random (exponential) movements and complex (heavy-tailed) processes, whereas movement during sleep lacked the heavy-tailed component. In contrast, inactivity followed a heavy-tailed process, lacking the random component. Activity patterns differed in nature between those with a diagnosis of bipolar disorder and a primary psychotic disorder. These results show the potential of complex models to quantify the rich nature of human movement captured by accelerometry during wake and sleep, and the interaction with diagnosis and health.

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“…Whilst light is commonly regarded as the most important input into the circadian system, physical activity is also associated with circadian alignment (Joo et al, 2016 ) and reduces the likelihood of falling asleep outside of the planned sleep window (Bonnet and Arand, 2000 ). Symptoms of psychosis and bipolar disorder are associated with disrupted circadian rhythms (Krane-Gartiser et al, 2016 ; Wulff et al, 2012 ) and on an inpatient ward, restricted leave can further disrupt the opportunity to engage in patients’ usual activities, exacerbating circadian dysregulation.…”

Section: Syncing Circadian Rhythms: Activity Schedulingmentioning

confidence: 99%

Adapted CBT to Stabilize Sleep on Psychiatric Wards: a Transdiagnostic Treatment Approach

Sheaves

Isham

Bradley

et al. 2018

Behav. Cogn. Psychother.

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Background: Almost all patients admitted at acute crisis to a psychiatric ward experience clinically significant symptoms of insomnia. Ward environments pose challenges to both sleep and the delivery of therapy. Despite this, there is no description of how to adapt cognitive behavioural therapy (CBT) for insomnia to overcome these challenges. Aims: (i) To describe the key insomnia presentations observed in the Oxford Ward Sleep Solution (OWLS) trial and (ii) outline key adaptations aimed to increase accessibility and hence effectiveness of CBT for insomnia for a ward setting. Methods: Trial therapists collaboratively agreed the key insomnia presentations and therapy adaptations based on their individual reflective logs used during the trial. Results: Three key insomnia presentations are outlined. These are used to illustrate the application of 10 CBT for insomnia therapy adaptations. These include use of sleep monitoring watches to engage patients in treatment, stabilizing circadian rhythms, reducing the impact of night-time observations and managing discharge as a sleep challenge. Conclusions: Whilst inpatient wards bring challenges for sleep and therapy delivery, creative adaptations can increase the accessibility of evidence based CBT for insomnia techniques. This therapy has proven popular with patients.

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Mood and motor activity in euthymic bipolar disorder with sleep disturbance

Cited by 23 publications

References 61 publications

Variability of activity patterns across mood disorders and time of day

Variability of activity patterns across mood disorders and time of day

Quantification of free-living activity patterns using accelerometry in adults with mental illness

Adapted CBT to Stabilize Sleep on Psychiatric Wards: a Transdiagnostic Treatment Approach

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