title: Sleep disturbances in euthymic bipolar patients.
abstract: BACKGROUND
  Sleep disturbance has been implicated in both prodromal and syndromal phases of bipolar illness.
  
  
  METHODS
  Charts of bipolar disorder (BD) patients who had been euthymic for at least 2 months were reviewed for mood symptoms, Clinical Global Impression scores, Global Assessment of Functioning scores, and sleep.
  
  
  RESULTS
  Among 116 patients, 10 never achieved a euthymic interval of 2 months' duration. Among the remaining 106 euthymic patients, 59 (55.6%) had BD I, 23 (21.7%) had BD II, and 24 (22.8%) had BD not otherwise specified (NOS). The mean age was 43.3±SD 14.6, and 35% were male. A total of 25 patients (23.6%) had a clinically significant ongoing sleep disturbance (27.1% of those with BD I, 21.7% of those with BD II, and 16.6% of those with BD NOS). Of 16 patients for whom a sleep description was available, 25% had difficulty falling asleep, 81.25% had middle insomnia (2 patients experienced both), and none had early morning awakening. Eleven patients (10.4%) received sleep aids, and 33 (31.1%) received sedating antipsychotics (3 patients received both).
  
  
  CONCLUSIONS
  Sleeping aids and sedating antipsychotics can potentially disguise an underlying sleep disturbance. Thus, it is possible that study patients taking these medications (n = 58; 54.7%) suffer from a sleep disturbance that is being adequately or inadequately treated.
authors.affiliation: Mood Disorders Research Program, Department of Psychiatry and Behavioral Science, University of Louisville School of Medicine, Louisville, KY, USA.
authors.forename: Sharon
authors.initials: S
authors.lastname: Brill
authors.forename: Praveen
authors.initials: P
authors.lastname: Penagaluri
authors.forename: R Jeannie
authors.initials: RJ
authors.lastname: Roberts
authors.forename: YongLin
authors.initials: Y
authors.lastname: Gao
authors.forename: Rif S
authors.initials: RS
authors.lastname: El-Mallakh
mesh_terms: D000328:Adult; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*; D015897:Comorbidity; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D007319:Sleep Initiation and Maintenance Disorders / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*
chemical_list: D014150:Antipsychotic Agents; D006993:Hypnotics and Sedatives