Prevalence of Circadian Rhythm Sleep-Wake Disorders and Associated Factors in Euthymic Patients with Bipolar Disorder

Abstract

Recent studies have suggested that there are certain pathophysiological relationships between bipolar disorder (BD) and circadian rhythm dysfunction. However, apparently no studies have clarified the prevalence of circadian rhythm sleep-wake disorders (CRSWD) in patients with BD. This study was set out to investigate the prevalence of CRSWD and associated factors in patients with BD. One hundred four euthymic BD outpatients participated in this study. The subjects were asked to answer questionnaires including demographic variables, clinical course of BD, and family history of psychiatric disorders and suicide. Severity of BD was assessed by the Montgomery-Åsberg Depression Rating Scale and Young Mania Rating Scale. CRSWD was diagnosed by clinical interview, together with sleep logs, according to the International Classification of Sleep Disorders, third edition (ICSD-3). Thirty-five subjects (32.4%) met the criteria for CRSWD. The age at the time of investigation and that at the onset of BD were both lower in the CRSWD group than in the non-CRSWD group. The rates of family history of psychiatric disorders and suicide in the CRSWD group were higher than those in the non-CRSWD group. Multiple logistic regression analysis revealed that the presence of CRSWD was significantly associated with younger onset age of BD and family history of suicide. The prevalence of CRSWD could be quite high in BD patients. Younger onset age of BD and family history of suicide were associated with presence of CRSWD in BD patients.

Circadian rhythm in bipolar disorder: A review of the literature

“…The aim of this review was to summarize and discuss the recent researches on the relations between circadian rhythm dysfunction and BD (listed in Table ). Moreover, I discuss the clinical implication of circadian rhythm dysfunction on the clinical diagnosis and treatment of BD.…”

“…Sleep disturbances have also been reported to be frequent in the euthymic state . Past studies have demonstrated that the sleep disturbances in the euthymic state included not only insomnia but also sleep–wake rhythm disorders, especially delayed sleep–wake phase disorders, suggesting that circadian rhythm dysfunction could be involved in the pathophysiology of BD. Pinho et al .…”

Solar insolation in springtime influences age of onset of bipolar I disorder

“…Clinical symptoms that are frequently reported include sleep timing disturbances , irregular daily schedules , and an evening preference . These symptoms of circadian disruption may occur during episodes, while euthymic , and in those at high risk for bipolar disorder . Even small changes to circadian rhythms such as the shift to daylight savings time may have adverse mental health consequences .…”

The Effects of Circadian Rhythm Disruption towards Metabolic Stress and Mental Health: A Review

“…The connection between the CR disruption and bipolar disorder (BD) also has been well documented in the past and current research. Takaesu et al (2016) explained the dysfunction of CR due to sleep disturbance among euthymic bipolar disorder (BD) patients. Participants went through a clinical interview and had a sleep log for researchers to monitor participants' sleeping pattern before they were categorised for sleep disorder according to International Classification of Sleep Disorders-3rd Edition…”