title: [Do sleep abnormalities contribute to cardiovascular risk in bipolar disorders?].
abstract: OBJECTIVE
  The aim of this review is to summarize the state of knowledge concerning the relationship between cardiovascular risk, sleep abnormalities, and emotional reactivity in patients with bipolar disorder (BD).
  
  
  METHODS
  A scientific literature search of international articles was performed during August and September 2014 using the PubMed electronic database. We used the following MeSH terms : "Bipolar Disorders", "Cardiovascular risk", "Emotional reactivity", "Sleep apnea", and "Sleep disorder".
  
  
  RESULTS
  Obstructive sleep apnea (OSA) is a sleep disorder strongly associated with BD, which tends to fragment sleep. OSA is associated with an increased cardiovascular risk. Furthermore, emotional hyper-reactivity is favored by "hostility" temperaments, BD and sleep deprivation. The combination of these factors interacts and also results in an increased cardiovascular risk. Taken as a whole, both sleep disorders and emotional hyper-reactivity seem to increase the risk of cardiovascular diseases in BD.
  
  
  CONCLUSIONS
  These data emphasize the central role of sleep abnormalities and emotional reactivity in the vulnerability of BD to express cardiovascular diseases. From a clinical point of view, these data also emphasize the importance of identifying and care for sleep abnormalities in BD in order to improve BD outcome.
authors.affiliation: Laboratoire de Neurosciences Cognitives (LNC), UMR CNRS 7291, 31 Aix-Marseille Université, 13331 Marseille cedex 3, France. Electronic address: jarthur.micoulaud@gmail.com.
authors.forename: J-A
authors.initials: JA
authors.lastname: Micoulaud Franchi
authors.affiliation: INSERM, UMR-S 1144, Paris, 75006 Paris, France.
authors.forename: P-A
authors.initials: PA
authors.lastname: Geoffroy
authors.affiliation: SHU Psychiatrie adultes, Solaris, Hôpital Ste Marguerite, 13274 Marseille cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Cermolacce
authors.affiliation: SHU Psychiatrie adultes, Solaris, Hôpital Ste Marguerite, 13274 Marseille cedex 9, France.
authors.forename: R
authors.initials: R
authors.lastname: Belzeaux
authors.affiliation: SHU Psychiatrie adultes, Solaris, Hôpital Ste Marguerite, 13274 Marseille cedex 9, France.
authors.forename: M
authors.initials: M
authors.lastname: Adida
authors.affiliation: SHU Psychiatrie adultes, Solaris, Hôpital Ste Marguerite, 13274 Marseille cedex 9, France.
authors.forename: J-M
authors.initials: JM
authors.lastname: Azorin
mesh_terms: D001143:Arousal; D001714:Bipolar Disorder / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004644:Emotions; D006801:Humans; D012307:Risk Factors; D012893:Sleep Wake Disorders / Q000150:complications / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology
keywords: Apnée du sommeil; Bipolar disorders; Cardiovascular risk; Emotional reactivity; Risque cardiovasculaire; Réactivité émotionnelle; Sleep apnea; Troubles bipolaires