Sleep in remitted bipolar disorder: A naturalistic case-control study using actigraphy

JOURNAL OF AFFECTIVE DISORDERS

卷:158

Article

Geoffroy, Pierre Alexis^1,3,4,5  Boudebesse, Carole^1,3,5  Bellivier, Frank^5,6,7  Lajnef, Mohamed¹  Henry, Chantal^1,2,3,5  Leboyer, Marion^1,2,3,5  Scott, Jan^8,9  Etain, Bruno^1,3,5 

[1] INSERM, U955, F-94000 Creteil, France

[2] Univ Paris Est, Fac Med, F-94000 Creteil, France

[3] Hop Henri Mondor, AP HP, F-94000 Creteil, France

[4] Univ Lille Nord France, CHRU Lille, F-59000 Lille, France

[5] Fdn FondaMental, F-94000 Creteil, France

[6] GH St Louis, AP HP, Paris, France

[7] Univ Paris 07, UFR Med, Paris, France

[8] Newcastle Univ, Inst Neurosci, Newcastle Upon Tyne NE1 7RU, Tyne & Wear, England

[9] Inst Psychiat, Ctr Affect Disorders, London, England

关键词: Bipolar disorder;    Actigraphy;    Euthymia;    Remission;    Sleep;    Circadian rhythms;   

DOI  :  10.1016/j.jad.2014.01.012

来源: Elsevier

【 摘 要 】

Introduction: Findings from acligraphic studies suggesting that sleep and circadian rhythms are disrupted in bipolar disorder (BD) patients have been undermined by methodological heterogeneity and the failure to adequately address potential confounders. Method: Twenty-six euthymic BD cases and 29 healthy controls (HC), recruited horn University Paris-Est and matched for age and gender, were compared on subjective (Pittsburgh Sleep Questionnaire Inventory; PQSI) and objective (mean scores and variability in actigraphy) measures of sleep as recorded by over 21 consecutive days. Results: Multivariate generalized linear modelling (GLM) revealed significant differences between BD cases and HC for five PSQI items (total score and four subscales), four actigraphy variables (mean scores) and five actigraphy variability measures. Backward stepwise linear regression (BSLR) indicated that a combination of four variables (mean sleep duration, mean sleep latency, variability of the fragmentation index over 21 days, and mean score on PSQI daytime dysfunction sub-scale) correctly classified 89% of study participants as cases or controls (Chi-square=39.81. df=6; p=0.001). Limitations: The sample size (although larger than most actigraphy studies) and incomplete matching of cases and controls may have influenced our findings It was not possible to control for potential effects of psychotropic medication or differences in employment status between groups. Conclusions: When potential confounders of sleep and circadian profiles are adequately taken into account (particularly age, gender, daytime sleepiness, mood symptoms, body mass index, and risk of sleep apnoea), a selected subset of quantitative (mean scores) and qualitative (variability) features differentiated euthymic BD cases from HC. (C) 2014 Elsevier B.V. All rights reserved.

【 授权许可】

Free