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Sleep quality during euthymia in bipolar disorder: the role of clinical features, personality traits, and stressful life events.

Saunders EF, Novick DM, Fernandez-Mendoza J, Kamali M, Ryan KA, Langenecker SA, Gelenberg AJ, McInnis MG - Int J Bipolar Disord (2013)

Bottom Line: Poor sleep quality often persists during euthymia and can be a target for treatment.Modifiable factors associated with sleep quality should be targeted directly with psychosocial or somatic treatment.Sleep quality may be a useful outcome measure in BD treatment studies.

View Article: PubMed Central - PubMed

Affiliation: University of Illinois at Chicago, Chicago, IL 60612 USA ; University of Illinois at Chicago, Chicago, IL 60612 USA ; University of Illinois at Chicago, Chicago, IL 60612 USA.

ABSTRACT

Background: Poor sleep quality is known to precede the onset of mood episodes and to be associated with poor treatment outcomes in bipolar disorder (BD). We sought to identify modifiable factors that correlate with poor sleep quality in BD independent of residual mood symptoms.

Methods: A retrospective analysis was conducted to assess the association between the Pittsburgh Sleep Quality Index and clinical variables of interest in euthymic patients with DSM-IV BD (n = 119) and healthy controls (HC; n = 136) participating in the Prechter Longitudinal Study of Bipolar Disorder. Multivariable linear regression models were constructed to investigate the relationship between sleep quality and demographic and clinical variables in BD and HC participants. A unified model determined independent predictors of sleep quality.

Results and discussion: Euthymic participants with BD and HC differed in all domains. The best fitting unified multivariable model of poor sleep quality in euthymic participants with BD included rapid cycling (β = .20, p = .03), neuroticism (β = .28, p = 2 × 10(-3)), and stressful life events (β = .20, p = .02). Poor sleep quality often persists during euthymia and can be a target for treatment. Clinicians should remain vigilant for treating subjective sleep complaints independent of residual mood symptoms in those sensitive to poor sleep quality, including individuals with high neuroticism, rapid cycling, and recent stressful life events. Modifiable factors associated with sleep quality should be targeted directly with psychosocial or somatic treatment. Sleep quality may be a useful outcome measure in BD treatment studies.

No MeSH data available.


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Independent risk factors for poor sleep quality in euthymic bipolar disorder.
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Fig1: Independent risk factors for poor sleep quality in euthymic bipolar disorder.

Mentions: In the final unified model, independent correlates of sleep quality in the BD group included rapid cycling (β = .20, p = .03), undesirable events (β = .20, p = .02), and neuroticism (β = .28, p = 2 × 10−3) (Table 4, Figure 1). Of the features of illness, suicide attempts were the most strongly correlated with sleep quality in the bivariate correlations, and remained significant in the model within the features of illness domain, but dropped out of the unified model. Mixed episodes were also significant in the bivariate correlations, but not in either the features of illness domain model or the unified model. Suicide attempts and rapid cycling were correlated with each other (r = .31, p = 1 × 10−3), and suicide attempts and mixed episodes were correlated with each other (r = .32, p = 1 × 10−3); however, rapid cycling and mixed episodes were not correlated (r = .13, p = .17). In the life story realm, Life Events Occurrence Survey (LEOS) undesirable events was the strongest correlate in the model by life story domain and remained significant in the unified analysis. Neuroticism was the strongest correlate in the personality assessment domain and in the unified analysis as well.Figure 1


Sleep quality during euthymia in bipolar disorder: the role of clinical features, personality traits, and stressful life events.

Saunders EF, Novick DM, Fernandez-Mendoza J, Kamali M, Ryan KA, Langenecker SA, Gelenberg AJ, McInnis MG - Int J Bipolar Disord (2013)

Independent risk factors for poor sleep quality in euthymic bipolar disorder.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4230686&req=5

Fig1: Independent risk factors for poor sleep quality in euthymic bipolar disorder.
Mentions: In the final unified model, independent correlates of sleep quality in the BD group included rapid cycling (β = .20, p = .03), undesirable events (β = .20, p = .02), and neuroticism (β = .28, p = 2 × 10−3) (Table 4, Figure 1). Of the features of illness, suicide attempts were the most strongly correlated with sleep quality in the bivariate correlations, and remained significant in the model within the features of illness domain, but dropped out of the unified model. Mixed episodes were also significant in the bivariate correlations, but not in either the features of illness domain model or the unified model. Suicide attempts and rapid cycling were correlated with each other (r = .31, p = 1 × 10−3), and suicide attempts and mixed episodes were correlated with each other (r = .32, p = 1 × 10−3); however, rapid cycling and mixed episodes were not correlated (r = .13, p = .17). In the life story realm, Life Events Occurrence Survey (LEOS) undesirable events was the strongest correlate in the model by life story domain and remained significant in the unified analysis. Neuroticism was the strongest correlate in the personality assessment domain and in the unified analysis as well.Figure 1

Bottom Line: Poor sleep quality often persists during euthymia and can be a target for treatment.Modifiable factors associated with sleep quality should be targeted directly with psychosocial or somatic treatment.Sleep quality may be a useful outcome measure in BD treatment studies.

View Article: PubMed Central - PubMed

Affiliation: University of Illinois at Chicago, Chicago, IL 60612 USA ; University of Illinois at Chicago, Chicago, IL 60612 USA ; University of Illinois at Chicago, Chicago, IL 60612 USA.

ABSTRACT

Background: Poor sleep quality is known to precede the onset of mood episodes and to be associated with poor treatment outcomes in bipolar disorder (BD). We sought to identify modifiable factors that correlate with poor sleep quality in BD independent of residual mood symptoms.

Methods: A retrospective analysis was conducted to assess the association between the Pittsburgh Sleep Quality Index and clinical variables of interest in euthymic patients with DSM-IV BD (n = 119) and healthy controls (HC; n = 136) participating in the Prechter Longitudinal Study of Bipolar Disorder. Multivariable linear regression models were constructed to investigate the relationship between sleep quality and demographic and clinical variables in BD and HC participants. A unified model determined independent predictors of sleep quality.

Results and discussion: Euthymic participants with BD and HC differed in all domains. The best fitting unified multivariable model of poor sleep quality in euthymic participants with BD included rapid cycling (β = .20, p = .03), neuroticism (β = .28, p = 2 × 10(-3)), and stressful life events (β = .20, p = .02). Poor sleep quality often persists during euthymia and can be a target for treatment. Clinicians should remain vigilant for treating subjective sleep complaints independent of residual mood symptoms in those sensitive to poor sleep quality, including individuals with high neuroticism, rapid cycling, and recent stressful life events. Modifiable factors associated with sleep quality should be targeted directly with psychosocial or somatic treatment. Sleep quality may be a useful outcome measure in BD treatment studies.

No MeSH data available.


Related in: MedlinePlus