title: Abnormalities in sleep patterns in individuals at risk for psychosis and bipolar disorder.
abstract: OBJECTIVE
  To compare patterns of sleep and the presence of sleep disturbances in individuals in at-risk mental states (ARMS) for psychosis and bipolar disorder (BD) with a healthy control (HC) group.
  
  
  METHODS
  This was a comparative study involving 20 individuals in ARMS for psychosis or BD, according to the Comprehensive Assessment of At-Risk Mental States, and 20 age- and sex-matched healthy controls. Quality of sleep in the previous month was assessed using the Pittsburgh Sleep Quality Index, diurnal somnolence was evaluated using The Epworth Sleepiness Scale, and chronotype was determined using the Questionnaire of Morningness/Eveningness (QME). All of the participants underwent polysomnography (PSG) during the entire night for two consecutive nights. The first night aimed to adapt the subject to the environment, and only the data from the second night were used for the analysis.
  
  
  RESULTS
  Compared with the HC group, individuals in the ARMS group reported significantly worse sleep quality, as measured by the Pittsburgh Sleep Quality Index. Both groups had scores consistent with daytime sleepiness on the Epworth Sleepiness Scale, and there were no differences with regard to chronotype between the groups, with a predominance of the indifferent type in both groups. In the PSG assessment, we observed increased Sleep Latency (SL) and increased Rapid Eye Movement Sleep Onset Latency (REMOL) in the ARMS group, compared to the HC group.
  
  
  CONCLUSIONS
  The results of this study indicated that sleep abnormalities could be found early in the course of mental diseases, even in at-risk stages, and support the further investigation of their predictive value in the transition to psychosis and BD.
authors.affiliation: Program for Recognition and Intervention in Individuals in At-Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Universidade Federal de São Paulo, São Paulo, Brazil; Sleep Institute, Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Marcio A
authors.initials: MA
authors.lastname: Zanini
authors.affiliation: Sleep Institute, Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Juliana
authors.initials: J
authors.lastname: Castro
authors.affiliation: Program for Recognition and Intervention in Individuals in At-Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Graccielle R
authors.initials: GR
authors.lastname: Cunha
authors.affiliation: Program for Recognition and Intervention in Individuals in At-Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Elson
authors.initials: E
authors.lastname: Asevedo
authors.affiliation: Program for Recognition and Intervention in Individuals in At-Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Pedro M
authors.initials: PM
authors.lastname: Pan
authors.affiliation: Sleep Institute, Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Lia
authors.initials: L
authors.lastname: Bittencourt
authors.affiliation: Sleep Institute, Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Fernando Morgadinho
authors.initials: FM
authors.lastname: Coelho
authors.affiliation: Sleep Institute, Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Sergio
authors.initials: S
authors.lastname: Tufik
authors.affiliation: Program for Recognition and Intervention in Individuals in At-Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Ary
authors.initials: A
authors.lastname: Gadelha
authors.affiliation: Program for Recognition and Intervention in Individuals in At-Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Universidade Federal de São Paulo, São Paulo, Brazil.
authors.forename: Rodrigo A
authors.initials: RA
authors.lastname: Bressan
authors.affiliation: Program for Recognition and Intervention in Individuals in At-Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Universidade Federal de São Paulo, São Paulo, Brazil. Electronic address: elisabrietzke@hotmail.com.
authors.forename: Elisa
authors.initials: E
authors.lastname: Brietzke
mesh_terms: D000293:Adolescent; D001714:Bipolar Disorder / Q000150:complications*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D008297:Male; D017286:Polysomnography; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000150:complications*; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000209:etiology*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: At-risk mental states; Bipolar disorder; Early stages; Polysomnography; Prodromal; Psychosis; Schizophrenia; Sleep