Sleep functioning in relation to mood, function, and quality of life at entry to the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD)

Abstract

Background Sleep disturbance in bipolar disorder can be both a risk factor and symptom of mood episodes. However, the associations among sleep and clinical characteristics, function, and quality of life in bipolar disorder have not been fully investigated. Methods The prevalence of sleep disturbance, duration, and variability, as well as their associations with mood, function, and quality of life, was determined from 2,024 bipolar patients enrolled in the National Institute of Mental Health Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD). Results Analyses indicated that 32% of patients were classified as short sleepers, 38% normal sleepers, and 23% long sleepers. Overall, short sleepers demonstrated greater mood elevation, earlier age at onset, and longer illness duration compared to both normal and long sleepers. Both short and long sleepers had greater depressive symptoms, poorer life functioning, and quality of life compared to normal sleepers. Discussion Short sleep duration in bipolar disorder was associated with a more severe symptom presentation, whereas both short and long sleep duration are associated with poorer function and quality of life compared to normal sleep duration. Sleep disturbance could be a trait marker of bipolar disorder, though longitudinal assessments are warranted to assess potential causal relations and the longer-term implications of sleep disturbance in bipolar disorder

Sleep Matters: Sleep Functioning and Course of Illness in Bipolar Disorder

“…Sleep functioning-We used two previously published variables to ascertain sleep functioning from the CMF, which included a single score for the maximum sleep in hours per night over the past week and a single score for the minimum sleep in hours slept per night over the past week (cf. Gruber et al, 2009). These variables were used to calculate (1) average total sleep time (TST) in the past week by averaging across the maximum and minimum sleep hours and (2) sleep variability (SV), calculated as the maximum minus the minimum sleep hours.…”

“…In fact, 70% of euthymic bipolar patients report clinically significant levels of sleep disturbance (Harvey et al, 2005). Cross-sectional research suggests that both short (<6 h) and long (≥ 9 h) sleep durations are associated with impaired functioning and quality of life in bipolar disorder (Gruber et al, 2009). …”

“…The first was to examine whether there was an association between sleep functioning and mood symptoms in recovered (i.e., euthymic) patients with bipolar disorder upon study entry into the Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD), a multi-site longitudinal study. Prior crosssectional and experimental evidence suggests that shortened total sleep duration is associated with increased depressive and manic symptom severity (e.g., Bauer et al, 2006;Colombo et al, 1999;Kasper and Wehr, 1992;Perlman et al, 2006;Wu and Bunney, 1990) as well as impaired functioning (e.g., Gruber et al, 2009). This aim focused on whether such associations are observable in a remitted bipolar sample.…”

The impact of Clinical Pharmacist Lead Collaborative Care on Quality Of Life of the Patients with Bipolar Disorder: A Unicenter Prospective, Randomization Study

“…6 Indeed, bipolar disorder is a severe, recurrent and chronic mental suffering, which may represent by the mood swing like dys-thymia, depression, euphoria, cyclothymia and mania at different time of interval in the same patient with significant functional and cognitive impairment. 7 Due to cyclic nature of bipolar disorder symptom remission and symptomatic exacerbation can affect the patients' physical; psychological, emotional, economic and social well-being which is directly impaired their overall quality of life. 8 The usual treatment of bipolar disorder in here pharmacotherapy and psycho-education, many patient responses adequately for such kind of approach but some of do not.…”

Adaptation of BRIAN-interview (Ukranian language version) for biological rhythms assessment at acute psychosis patients

“…Grandin et al 2006 [2] pointed out that irregular circadian rhythms lead to mood disorders in vulnerable individuals. Some authors drew attention to the relationship between behavior, cognition, affect and impairment of biological rhythms [3], [4], others noted that inner rhythm is essential component of everyday human life [5]. There are evidences that impairment of the biological rhythm predicts poor functioning and quality of life [6].…”