title: Relationship between sleep disturbance and recovery in patients with borderline personality disorder.
abstract: OBJECTIVE
  Patients with borderline personality disorder (BPD) frequently experience sleep disturbance, however, the role of sleep quality in the course of BPD is unknown. The purpose of this study was to evaluate the cross-sectional association between sleep quality and recovery status (symptomatic remission plus good concurrent psychosocial functioning) in a well-characterized cohort of patients with BPD to examine the role of sleep disturbance in the course of the disorder.
  
  
  METHODS
  223 patients with BPD participating in the McLean Study of Adult Development (MSAD) were administered the Pittsburgh Sleep Quality Index (PSQI) as part of the 16-year follow-up wave. Sleep quality was compared between recovered (n=105) and non-recovered (n=118) BPD participants, including adjustment for age, sex, depression, anxiety, and primary sleep disorders.
  
  
  RESULTS
  Non-recovered BPD patients had significantly worse sleep quality than recovered BPD participants as measured by the global PSQI score (adjusted means 12.01 vs. 10.73, p=0.03). In addition, non-recovered BPD participants had longer sleep onset latency (adjusted means 39.20 vs. 28.11minutes, p=0.04), as well as increased odds of using sleeping medication (adjusted OR 1.49, p=0.009) and experiencing daytime dysfunction as a result of their sleep disturbance (adjusted OR 1.48, p=0.008).
  
  
  CONCLUSIONS
  These results demonstrate an association between subjective sleep disturbance and recovery status among BPD patients. Further research is indicated to evaluate the mechanisms underlying sleep disturbance in BPD, and whether treatment of sleep complaints improves the symptomatic and psychosocial course of the disorder.
authors.affiliation: Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA. dplante@wisc.edu
authors.forename: David T
authors.initials: DT
authors.lastname: Plante
authors.forename: Frances R
authors.initials: FR
authors.lastname: Frankenburg
authors.forename: Garrett M
authors.initials: GM
authors.lastname: Fitzmaurice
authors.forename: Mary C
authors.initials: MC
authors.lastname: Zanarini
mesh_terms: D000328:Adult; D001883:Borderline Personality Disorder / Q000150:complications / Q000503:physiopathology* / Q000523:psychology; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012893:Sleep Wake Disorders / Q000150:complications / Q000503:physiopathology* / Q000523:psychology