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. 2023 May:323:115136.
doi: 10.1016/j.psychres.2023.115136. Epub 2023 Feb 28.

Sleep changes during a spontaneous manic episode: PSG assessment in a clinical context

F Pacchioni  1 , M C Cavallini  2 , L Fregna  2 , F Casoni  3 , A Sarzetto  4 , F Attanasio  4 , B Barbini  2 , M Locatelli  2 , C Colombo  5
Affiliations

Sleep changes during a spontaneous manic episode: PSG assessment in a clinical context

F Pacchioni et al. Psychiatry Res. 2023 May.

Abstract

Sleep plays a key role in the pathogenesis and clinical presentation of mood disorders. However, only a few studies have investigated sleep architecture during the manic episodes of Bipolar Disorder (BD) and changes in sleep parameters that follow clinical variations. Twenty-one patients (8 males, 13 females) affected by BD, manic phase, underwent polysomnographic recordings (PSG) at the beginning of the admission in our ward (T0) and after three weeks of hospital treatment (T1). All participants were clinically evaluated using Young Mania Rating Scale (YMRS), Pittsburgh Sleep Quality Index (PSQI) and Morningness-Eveningness Questionnaire (MEQ). During the admission, we observed an increase in both quantity (Total Sleep Time - TST) and quality (Sleep Efficiency - SE) of sleep. In addition, clinical improvement, evaluated with YMRS and PSQI scales, was accompanied by a significant increase in the percentage of REM sleep. According to our findings, the improvement of manic symptoms is accompanied by an increase in "REM pressure" (increase in REM% and REM density, reduction of REM latency). Overall, changes in sleep architecture appear to be markers sensitive to clinical variations during manic phases of Bipolar Disorder.

Keywords: Bipolar disorder; Mania; PSG; REM; Sleep.

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Conflict of interest statement

Declaration of Competing Interest We confirm that this work is original and has not been published elsewhere. We have no conflicts of interest to disclose.