Sleep and circadian rhythm disturbance in bipolar disorder.
BACKGROUND
Subjective reports of insomnia and hypersomnia are common in bipolar disorder (BD). It is unclear to what extent these relate to underlying circadian rhythm disturbance (CRD). In this study we aimed to objectively assess sleep and circadian rhythm in a cohort of patients with BD compared to matched controls.


METHODS
Forty-six patients with BD and 42 controls had comprehensive sleep/circadian rhythm assessment with respiratory sleep studies, prolonged accelerometry over 3 weeks, sleep questionnaires and diaries, melatonin levels, alongside mood, psychosocial functioning and quality of life (QoL) questionnaires.


RESULTS
Twenty-three (50%) patients with BD had abnormal sleep, of whom 12 (52%) had CRD and 29% had obstructive sleep apnoea. Patients with abnormal sleep had lower 24-h melatonin secretion compared to controls and patients with normal sleep. Abnormal sleep/CRD in BD was associated with impaired functioning and worse QoL.


CONCLUSIONS
BD is associated with high rates of abnormal sleep and CRD. The association between these disorders, mood and functioning, and the direction of causality, warrants further investigation.
Institute of Neuroscience,Newcastle University,Wolfson Research Centre,Campus for Aging and Vitality,Newcastle Upon Tyne,UK.
A J
AJ
Bradley
Institute of Neuroscience,Newcastle University,Wolfson Research Centre,Campus for Aging and Vitality,Newcastle Upon Tyne,UK.
R
R
Webb-Mitchell
Institute of Neuroscience,Newcastle University,Wolfson Research Centre,Campus for Aging and Vitality,Newcastle Upon Tyne,UK.
A
A
Hazu
Institute of Neuroscience,Newcastle University,Wolfson Research Centre,Campus for Aging and Vitality,Newcastle Upon Tyne,UK.
N
N
Slater
Surrey Sleep Research Centre and Centre for Chronobiology,Faculty of Health and Medical Sciences,University of Surrey,Guildford,UK.
B
B
Middleton
Institute of Neuroscience,Newcastle University,Wolfson Research Centre,Campus for Aging and Vitality,Newcastle Upon Tyne,UK.
P
P
Gallagher
Institute of Neuroscience,Newcastle University,Wolfson Research Centre,Campus for Aging and Vitality,Newcastle Upon Tyne,UK.
H
H
McAllister-Williams
Regional Sleep Service, Freeman Hospital,High Heaton,Newcastle upon Tyne,UK.
K N
KN
Anderson
D000328:Adult; D001714:Bipolar Disorder / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology; D002940:Circadian Rhythm / Q000502:physiology*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008550:Melatonin / Q000378:metabolism*; D008875:Middle Aged; D020181:Sleep Apnea, Obstructive / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology; D020178:Sleep Disorders, Circadian Rhythm / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000378:metabolism / Q000503:physiopathology; D055815:Young Adult
D008550:Melatonin
Bipolar; circadian rhythm; cognition; melatonin; sleep.