Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Nov;134(1-3):416-20.
doi: 10.1016/j.jad.2011.05.016. Epub 2011 Jun 17.

Sleep matters: sleep functioning and course of illness in bipolar disorder

June Gruber  1 , David J Miklowitz, Allison G Harvey, Ellen Frank, David Kupfer, Michael E Thase, Gary S Sachs, Terence A Ketter
Affiliations

Sleep matters: sleep functioning and course of illness in bipolar disorder

June Gruber et al. J Affect Disord. 2011 Nov.

Abstract

Background: Few studies have prospectively examined the relationships of sleep with symptoms and functioning in bipolar disorder.

Methods: The present study examined concurrent and prospective associations between total sleep time (TST) and sleep variability (SV) with symptom severity and functioning in a cohort of DSM-IV bipolar patients (N = 468) participating in the National Institute of Mental Health Systematic Treatment Enhancement Program for Bipolar Disorder (STEP-BD), all of whom were recovered at study entry.

Results: Concurrent associations at study entry indicated that shorter TST was associated with increased mania severity, and greater SV was associated with increased mania and depression severity. Mixed-effects regression modeling was used to examine prospective associations in the 196 patients for whom follow-up data were available. Consistent with findings at study entry, shorter TST was associated with increased mania severity, and greater SV was associated with increased mania and depression severity over 12 months.

Discussion: These findings highlight the importance of disrupted sleep patterns in the course of bipolar illness.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest

The authors declare no conflicts of interest related to the content of this article.

Figures

Fig. 1
Fig. 1
TST and SUM-M scores across 12 months.
Fig. 2
Fig. 2
SV, SUM-M, SUM-D, and GAF scores across 12 months.
See this image and copyright information in PMC

References

    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4. APA; Washington, DC: 2000. text revision.
    1. Barbini B, Bertelli S, Colombo C, Smeraldi E. Sleep loss, a possible factor in augmenting manic episode. Psychiatry Research. 1996;65:121–125. - PubMed
    1. Barbini B, Colombo C, Benedetti F, Campori E, Bellodi L, Smeraldi E. The unipolar–bipolar dichotomy and the response to sleep deprivation. Psychiatry Research. 1998;79 (1):43–50. - PubMed
    1. Bauer M, Grof P, Rasgon N, Bschor T, Glenn T, Whybrow PC. Temporal relation between sleep and mood in patients with bipolar disorder. Bipolar Disorders. 2006;8 (2):160–167. - PubMed
    1. Colombo C, Benedetti F, Barbini B, Campori E, Smeraldi E. Rate of switch from depression into mania after therapeutic sleep deprivation in bipolar depression. Psychiatry Research. 1999;86:267–270. - PubMed

Publication types