Circadian variability of objective sleep measures predicts the relapse of a mood episode in bipolar disorder: findings from the APPLE cohort

Yuichi Esaki, Kenji Obayashi, Keigo Saeki, Kiyoshi Fujita, Nakao Iwata, Tsuyoshi Kitajima

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Aim: Sleep disturbance, a core feature of bipolar disorder, is closely associated with mood symptoms. We examined the association between actigraphy sleep parameters and mood episode relapses in patients with bipolar disorder. Methods: This prospective cohort study analyzed 193 outpatients with bipolar disorder who participated in the Association between the Pathology of Bipolar Disorder and Light Exposure in Daily Life (APPLE) cohort study. The participants' sleep was objectively evaluated via actigraphy over seven consecutive days for the baseline assessment and then at the 2-year follow-up appointment for mood episode relapses. The actigraphy sleep parameters were presented using the mean and variability (standard deviation) of each sleep parameter for 7 days. Results: Of the 193 participants, 110 (57%) experienced mood episodes during follow-up. The participants with higher variability in total sleep time had a significantly shorter mean estimated time to mood episode relapses than those with lower variability (12.5 vs. 16.8 months; P < 0.001). The Cox proportional hazards model, when adjusted for potential confounders, demonstrated that variability in total sleep time was significantly associated with an increase in the mood episode relapses (per hour; hazard ratio [HR], 1.407; 95% confidence interval (CI), 1.057–1.873), mainly in the depressive episodes (per hour; HR, 1.477; 95% CI, 1.088–2.006). Conclusions: Our findings suggest that consistency in sleep time might be useful, as an adjunct therapy, in preventing the recurrence or relapse of mood episodes in bipolar disorder.

Original languageEnglish
Pages (from-to)442-448
Number of pages7
JournalPsychiatry and clinical neurosciences
Volume77
Issue number8
DOIs
Publication statusPublished - 08-2023

All Science Journal Classification (ASJC) codes

  • General Neuroscience
  • Neurology
  • Clinical Neurology
  • Psychiatry and Mental health

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