Disentangling Subjective Sleep and Objective Cognition: Insights From Two Independent Cross-Sectional Cohorts of Remitted Bipolar Disorder

IF 4.5 2区医学 Q1 CLINICAL NEUROLOGY

Bipolar Disorders Pub Date : 2025-08-22 DOI:10.1111/bdi.70051

Jeff Zarp, Hanne Lie Kjærstad, Maria Nesje Porten, Lars Vedel Kessing, Kamilla Woznica Miskowiak

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引用次数: 0

Abstract

Objectives

Cognitive impairment during remission in bipolar disorder (BD) hampers functional recovery. While diverse factors can impact these impairments, sleep disturbance is considered a key component. This cross-sectional report aimed to analyze the association between subjective sleep characteristics and objective cognitive impairment in two independent samples of remitted outpatients with BD.

Methods

Baseline data, including neuropsychological test performances and questionnaire-based sleep quality, subjective cognitive complaints, and mood ratings, were pooled from two clinical trials. Eighteen- to sixty-four-year-old fully or partially remitted outpatients with BD were divided into two independent cohorts: (i) newly diagnosed patients classified as cognitively impaired (n = 40) or normal (n = 58) according to hierarchical cluster analysis and matching healthy controls (HC) (n = 80), as well as (ii) patients with longer duration of illness prescreened for cognitive impairment (n = 115) and matching HC (n = 75). Subjective sleep quality was assessed with the Pittsburgh Sleep Quality Index (PSQI). Correlational and multiple linear regression analyses investigated associations between cognition and sleep.

Results

In age-, sex-, and medication-adjusted regression analyses, subjectively reported sleep quality (PSQI total score) was not associated with objective cognitive impairment globally or across domains in any cohort. Instead, worse subjective sleep quality was associated with more subjective cognitive complaints, greater subsyndromal depression symptoms, and receiving antipsychotic medication.

Conclusions

Our findings support the view that objective cognitive impairments in remitted patients with BD, whether newly diagnosed or with longer illness duration, may not be solely attributable to subjectively reported sleep disturbances. This adds to emerging evidence suggesting cognition as a relevant treatment target in BD.

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解开主观睡眠和客观认知的纠缠：来自两个独立的横截面队列的见解缓解双相情感障碍。

目的：双相情感障碍（BD）缓解期认知障碍阻碍功能恢复。虽然影响这些损伤的因素多种多样，但睡眠障碍被认为是一个关键因素。本横断面报告旨在分析两个独立的门诊bd患者的主观睡眠特征与客观认知障碍之间的关系。方法：收集两项临床试验的基线数据，包括神经心理测试表现和问卷睡眠质量、主观认知抱怨和情绪评分。18 - 64岁完全或部分缓解的门诊BD患者被分为两个独立的队列：(i)根据分层聚类分析和匹配健康对照（HC）（n = 80）分类为认知障碍（n = 40）或正常（n = 58）的新诊断患者，以及（ii）预先筛查为认知障碍的病程较长的患者（n = 115）和匹配HC （n = 75）。采用匹兹堡睡眠质量指数（PSQI）评估主观睡眠质量。相关和多元线性回归分析研究了认知和睡眠之间的关系。结果：在年龄、性别和药物调整的回归分析中，主观报告的睡眠质量（PSQI总分）与全球或跨领域的客观认知障碍无关。相反，较差的主观睡眠质量与更多的主观认知抱怨、更大的亚综合征性抑郁症状和接受抗精神病药物有关。结论：我们的研究结果支持这样一种观点，即缓解的双相障碍患者的客观认知障碍，无论是新诊断的还是病程较长的患者，都可能不完全归因于主观报告的睡眠障碍。这增加了新的证据表明认知是双相障碍的相关治疗靶点。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Bipolar Disorders 医学-精神病学

CiteScore

8.20

自引率

7.40%

发文量

审稿时长

6-12 weeks

期刊介绍： Bipolar Disorders is an international journal that publishes all research of relevance for the basic mechanisms, clinical aspects, or treatment of bipolar disorders and related illnesses. It intends to provide a single international outlet for new research in this area and covers research in the following areas: biochemistry physiology neuropsychopharmacology neuroanatomy neuropathology genetics brain imaging epidemiology phenomenology clinical aspects and therapeutics of bipolar disorders Bipolar Disorders also contains papers that form the development of new therapeutic strategies for these disorders as well as papers on the topics of schizoaffective disorders, and depressive disorders as these can be cyclic disorders with areas of overlap with bipolar disorders. The journal will consider for publication submissions within the domain of: Perspectives, Research Articles, Correspondence, Clinical Corner, and Reflections. Within these there are a number of types of articles: invited editorials, debates, review articles, original articles, commentaries, letters to the editors, clinical conundrums, clinical curiosities, clinical care, and musings.