title: Comparison of sleep/wake parameters for self-monitoring bipolar disorder.
abstract: BACKGROUND
  Psychosocial interventions may teach patients with bipolar disorder to successfully detect warning signs of relapse. These interventions often include ongoing self-monitoring of sleep. We previously reported that a change in sleep duration (sleep plus bedrest) of >3 h may indicate that a mood change is imminent. This analysis further investigated whether sleep duration, sleep onset or sleep offset was the most useful sleep/wake parameter to monitor for an oncoming mood change.
  
  
  METHODS
  101 adult outpatients receiving treatment as usual recorded mood, sleep and medications every day on a home computer for a mean of 265+/-103 days. A daily time series of mood, sleep duration (sleep plus bedrest), sleep onset and sleep offset was constructed for each patient. After applying an ARIMA (0,1,1) filter, a cross correlation function was used to analyze the temporal relationship between the residuals for lags of +/-7 days.
  
  
  RESULTS
  Less frequent significant correlations were found between a change in either sleep onset or sleep offset and mood, than between sleep duration and mood. Patients with a significant correlation between sleep duration and mood included 86% of those with a significant correlation between sleep onset or sleep offset and mood. Mean sleep duration when euthymic was long (> or =8 h in 89% of patients, > or =9 h in 51% of patients).
  
  
  CONCLUSIONS
  Self-reported data, naturalistic study, and computer access required.
  
  
  CONCLUSIONS
  Self-monitoring of sleep duration is recommended for patients with bipolar disorder. Better understanding of the long sleep duration of euthymic patients is required.
authors.affiliation: Department of Psychiatry and Psychotherapy, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. michael.bauer@uniklinikum-dresden.de
authors.forename: Michael
authors.initials: M
authors.lastname: Bauer
authors.forename: Tasha
authors.initials: T
authors.lastname: Glenn
authors.forename: Paul
authors.initials: P
authors.lastname: Grof
authors.forename: Natalie
authors.initials: N
authors.lastname: Rasgon
authors.forename: Martin
authors.initials: M
authors.lastname: Alda
authors.forename: Wendy
authors.initials: W
authors.lastname: Marsh
authors.forename: Kemal
authors.initials: K
authors.lastname: Sagduyu
authors.forename: Rita
authors.initials: R
authors.lastname: Schmid
authors.forename: Mazda
authors.initials: M
authors.lastname: Adli
authors.forename: Peter C
authors.initials: PC
authors.lastname: Whybrow
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology* / Q000523:psychology; D004358:Drug Therapy; D005260:Female; D006801:Humans; D008297:Male; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D012008:Recurrence; D020377:Self Efficacy; D020178:Sleep Disorders, Circadian Rhythm / Q000453:epidemiology*; D055815:Young Adult