Comparison of sleep/wake parameters for self-monitoring bipolar disorder.
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.
Bauer
Michael
M
Department of Psychiatry and Psychotherapy, Universitätsklinikum Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany. michael.bauer@uniklinikum-dresden.de
Glenn
Tasha
T
Grof
Paul
P
Rasgon
Natalie
N
Alda
Martin
M
Marsh
Wendy
W
Sagduyu
Kemal
K
Schmid
Rita
R
Adli
Mazda
M
Whybrow
Peter C
PC
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