Hypersomnia in inter-episode bipolar disorder: does it have prognostic significance?

Abstract

Background: Hypersomnia in inter-episode bipolar disorder has been minimally researched. The current study sought to document the prevalence of hypersomnia in a sample of inter-episode patients with bipolar disorder and to examine the relationship between hypersomnia and future bipolar depressive symptoms.

Methods: A total of 56 individuals with bipolar disorder (51 type I+5 type II) who were currently inter-episode, along with 55 non-psychiatric controls, completed a baseline assessment, including semi-structured interviews for psychiatric diagnoses, sleep disorders, and a battery of indices that included assessment of hypersomnia. Approximately 6 months later, participants were recontacted by telephone and mood was re-evaluated.

Results: Three of six indices suggested that approximately 25% of participants with bipolar disorder endorsed symptoms of hypersomnia in the inter-episode period. Within the bipolar group, hypersomnia in the inter-episode period was associated with future depressive symptoms. This finding was independent of baseline depressive symptoms and medication use.

Limitations: Small sample size and concurrent psychopharmacology in the bipolar sample.

Discussion: Though no gold standard measure for hypersomnia currently exists, this research takes a step towards identifying a clinically and empirically useful hypersomnia assessment. This study demonstrates that hypersomnia in the inter-episode period of bipolar disorder relates to future depressive symptoms, and adds to the growing body of evidence on the importance of inter-episode symptoms predicting bipolar relapse.