Jeff Zarp, Hanne Lie Kjærstad, Maria Nesje Porten, Lars Vedel Kessing, Kamilla Woznica Miskowiak
{"title":"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。","authors":"Jeff Zarp, Hanne Lie Kjærstad, Maria Nesje Porten, Lars Vedel Kessing, Kamilla Woznica Miskowiak","doi":"10.1111/bdi.70051","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objectives</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>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 (<i>n</i> = 40) or normal (<i>n</i> = 58) according to hierarchical cluster analysis and matching healthy controls (HC) (<i>n</i> = 80), as well as (ii) patients with longer duration of illness prescreened for cognitive impairment (<i>n</i> = 115) and matching HC (<i>n</i> = 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.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>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.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>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.</p>\n </section>\n </div>","PeriodicalId":8959,"journal":{"name":"Bipolar Disorders","volume":"27 6","pages":"435-448"},"PeriodicalIF":4.5000,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Disentangling Subjective Sleep and Objective Cognition: Insights From Two Independent Cross-Sectional Cohorts of Remitted Bipolar Disorder\",\"authors\":\"Jeff Zarp, Hanne Lie Kjærstad, Maria Nesje Porten, Lars Vedel Kessing, Kamilla Woznica Miskowiak\",\"doi\":\"10.1111/bdi.70051\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Objectives</h3>\\n \\n <p>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. 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Disentangling Subjective Sleep and Objective Cognition: Insights From Two Independent Cross-Sectional Cohorts of Remitted Bipolar Disorder
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.
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.
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