The role of disturbed sleep in the early recognition of bipolar disorder: a systematic review

Ritter, Philipp; Marx, Carolin; Bauer, Michael; Leopold, Karolina; Pfennig, Andrea

doi:10.1111/j.1399-5618.2011.00917.x

Cited by 63 publications

(53 citation statements)

References 64 publications

(91 reference statements)

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“…Additionally, Ritter and colleagues 71 point to the significance of sleep disturbances for mood disorders in general, and for BP-spectrum disorders in particular, concluding that sleep disturbances did not begin in childhood, but emerged in adolescence, being a significant risk factor for BP-spectrum disorders.…”

Section: Evidence For a Presence Of A Bipolar–i Disorder Prodrome In mentioning

confidence: 99%

The Significance of At-Risk or Prodromal Symptoms for Bipolar I Disorder in Children and Adolescents

Hauser

Correll

2013

Can J Psychiatry

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Background While in the early identification and intervention of psychosis, specific instruments and risk criteria have been generated and validated, research into preventive strategies for bipolar-I disorder (BP-I) has only recently gained momentum. Since first signs of BP-I often start before adulthood, such efforts are especially important in the vulnerable pediatric population. Methods Narrative review of data regarding the presence and nature of potentially prodromal, i.e., sub-syndromal, symptoms prior to BP-I, defined by first-episode mania, focusing on pediatric patients. Results The possibility of early identification of youth at high-risk for BP is supported by retrospective studies of BP-I patients, and prospective studies of community samples, offspring of BP-I subjects, youth with depressive disorders, and patients at high-risk for psychosis or with BP-spectrum disorders without lifetime history of mania. These data provide essential insight into potential signs and symptoms that may enable pre-syndromal identification of BP-I in youth. However, except for offspring studies, broader prospective approaches that focus on youth at risk for BP-I and on developing specific interviews/rating scales and risk criteria are mostly missing, or in their early stage. Conclusions More work is needed to determine valid clinical high-risk criteria, to distinguish risk factors, endophenotypes and comorbidities from specific prodromal symptomatology, and to develop phase-specific interventions that titrate the risk of intervention to the risk of transition to mania and to functional impairment or distress. Moreover, studies are needed that determine potential differences in prodromal symptoms and trajectories between children, adolescents and adults, and the best phase-specific interventions.

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Section: Evidence For a Presence Of A Bipolar–i Disorder Prodrome In mentioning

confidence: 99%

The Significance of At-Risk or Prodromal Symptoms for Bipolar I Disorder in Children and Adolescents

Hauser

Correll

2013

Can J Psychiatry

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“…Euthymic and non-euthymic BD adolescents have more difficulties falling asleep and have more frequent and longer night awakenings than healthy adolescents [48]. Moreover, sleep disturbances often precede the diagnosis of BD in childhood and adolescence [49]. Reports of objective findings are rare and the few polysomnography studies show that depressed adolescents who later developed BD had initially more stage 1 and less stage 4, increased REM latency, lower REM density, and less REM sleep than the unipolar group who never developed BD.…”

Section: Introduction Contextmentioning

confidence: 98%

Sleep-Wake Patterns of Adolescents with Borderline Personality Disorder and Bipolar Disorder

Huỳnh

Guilé

Breton

2015

Child Psychiatry Hum Dev

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Sleep-wake patterns are rarely examined in adolescents with borderline personality disorder (BPD) or bipolar disorder (BD). Within a developmental perspective, this study explores the sleep-wake cycle of adolescents aged 12-17 years with BPD or BD and healthy controls (HC) during periods with and without entrainment by school/work schedules. Eighteen euthymic BPD, six euthymic BD, and 20 HC adolescents wore wrist actigraphy during nine consecutive days to assess sleep-wake patterns. During school/work days, BPD adolescents spent more time awake when they were in bed compared to HC and BD adolescents (p = 0.039). On schedule-free days, BPD and BD youths spent more time in bed compared to HC adolescents (p = 0.015). BPD adolescents woke up over 1 h later compared to HC (p = 0.003). Total sleep time was more variable between nights in BPD adolescents compared to the HC group (p = 0.031). Future research should explore if sleep-wake pattern disruptions are a cause or a consequence of BPD symptomatology in adolescents. Addressing sleep-wake pattern during clinical assessment and treatment of BPD adolescents may potentially reduce their symptoms; this therapeutic effect still needs to be evaluated.

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“…Disturbed sleep is a predictor of BD onset in at-risk samples (Levenson et al, 2015; Ritter et al, 2011), it is prospectively linked to worsening symptoms of mania and depression in youth with BD (Lunsford-Avery et al, 2012), and it is the top prodromal symptom of mania in adult BD (Jackson et al, 2003). Sleep loss , or short sleep duration, may have particular importance to the emergence of mood dysregulation characteristic of BD.…”

Section: Introductionmentioning

confidence: 99%

Preliminary investigation of the relationships between sleep duration, reward circuitry function, and mood dysregulation in youth offspring of parents with bipolar disorder

Soehner

Bertocci

Manelis

et al. 2016

Journal of Affective Disorders

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Background Altered reward circuitry function is observed in individuals with bipolar disorder (BD) and their unaffected offspring (OBP). While OBP are at elevated risk for BD, modifiable risk factors that may exacerbate neural vulnerabilities in OBP remain under-characterized. As sleep loss is strongly linked to mania in BD, this study tested associations between sleep duration, reward circuitry function, and mood dysregulation in OBP. Methods Two groups of youth unaffected with BD (9-17yr) completed a number-guessing fMRI reward paradigm: 25 OBP and 21 age-sex-IQ-matched offspring of control parents with non-BD psychopathology (OCP), to differentiate risk for BD from risk for psychopathology more broadly. Regressions tested effects of group status, self-reported past-week sleep duration, and their interaction on neural activity and bilateral ventral striatum(VS) functional connectivity to win>control. Correlations with parent-reported mood dysregulation were assessed. Results Group effects were observed for right posterior insula activity (OCP>OBP) and VS-left posterior insula connectivity (OBP>OCP). Group*sleep duration interactions were observed for left dorsal anterior-mid-cingulate(daMCC) activity and VS-left anterior insula/ventrolateral prefrontal cortex(VLPFC) connectivity. Specifically, sleep duration and daMCC activity were positively related in OBP, but negatively related in OCP and sleep duration and VS-left anterior insula/VLPFC connectivity were negatively related in OBP, but positively in OCP. Additionally, increased VS-left posterior insula connectivity and VS-left anterior insula/VLPFC connectivity were associated with greater mood dysregulation in OBP only. Limitations Cross-sectional design and small sample size. Conclusions Altered reward-related VS-insula connectivity could represent a neural pathway underpinning mood dysregulation in OBP, and may be modulated by shortened sleep duration.

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The role of disturbed sleep in the early recognition of bipolar disorder: a systematic review

Abstract: Disturbed sleep appears to be an early symptom of bipolar disorder but further research, especially longitudinal studies in individuals at high risk, will be required to characterize the type and patterns more precisely.

Cited by 63 publications

References 64 publications

The Significance of At-Risk or Prodromal Symptoms for Bipolar I Disorder in Children and Adolescents

The Significance of At-Risk or Prodromal Symptoms for Bipolar I Disorder in Children and Adolescents

Sleep-Wake Patterns of Adolescents with Borderline Personality Disorder and Bipolar Disorder

Preliminary investigation of the relationships between sleep duration, reward circuitry function, and mood dysregulation in youth offspring of parents with bipolar disorder

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