睡眠参数能否预测双相情感障碍患者即将到来的情绪发作?

IF 4.5 2区 医学 Q1 CLINICAL NEUROLOGY
Andrea Ulrichsen, Esther Mühlbauer, Lisa-Marie Hartnagel, Emanuel Severus, Anthony Cleare, Sameer Jauhar, Michael Bauer, Ulrich Ebner-Priemer
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引用次数: 0

摘要

背景:双相情感障碍(BD)是一种复发性疾病,以发作(轻度)躁狂、抑郁和心境愉悦为特征,伴有情绪、认知和睡眠的变化。许多患者在发作前就发现了睡眠的变化;使用每日睡眠日志可以帮助识别这些变化。这些早期预警信号对于患者和临床医生来说都是一个有价值的工具,可以预测和准备情绪的变化。方法:在BipoSense研究中,我们对在研究开始时处于缓解期的BD患者进行了为期1年的每日随访。患者通过应用程序每小时报告一次他们是醒着还是睡着,并每两周接受一次双相情感障碍症状的临床评估。我们采用以人为中心的数据进行统计分析,在多层次logit模型中调查睡眠模式是否可以区分发作前(前驱期)和精神愉悦期,观察睡眠的平均变化和可变性。采用Bonferroni-Holm修正以避免多重检验中I型误差的膨胀。结果:纳入29例受试者(平均年龄44.0岁[SD = 11.9],女性55%,BD-I 59%)。晚醒与前驱抑郁症有关,是前驱情绪发作的唯一重大发现。睡眠时间、总卧床时间和起床时间的变化与前驱抑郁症有关;入睡时间和醒来时间的变异性较小与前驱(轻度)躁狂有关。结论:使用自我评估的睡眠变化,尤其是变异性,可以作为帮助患者识别情绪复发早期预警信号的潜在工具;然而,这些分析是探索性的,需要进一步的调查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Can Sleep Parameters Predict Upcoming Mood Episodes in Bipolar Disorder?

Can Sleep Parameters Predict Upcoming Mood Episodes in Bipolar Disorder?

Background

Bipolar disorder (BD) is a recurrent disorder, characterised by episodes of (hypo)mania, depression and euthymia with variation in mood, cognition and sleep. Many patients identify changes in sleep before an episode; using daily sleep logs could help identify these changes. Such early warning signs can be a valuable tool for patients and clinicians alike in predicting and preparing for changes in mood.

Methods

In the BipoSense study, we followed patients with BD, who were in remission at the start of the study, daily for 1 year. Patients reported for each hour if they were awake or asleep through an app and received fortnightly clinical assessments of bipolar symptoms. We used statistical analyses applying person-centred data in multilevel logit models to investigate if sleep patterns could differentiate between the period before an episode (prodromal stage) and euthymia, looking at both mean changes and variability of sleep. Bonferroni-Holm corrections were applied to avoid inflation of type I errors from multiple testing.

Results

Twenty-nine participants were included (mean age 44.0 years [SD = 11.9], female 55% and BD-I 59%). Waking up later was associated with prodromal depression and was the only significant finding for prodromal mood episodes. Greater variability of sleep duration, total time spent in bed and time waking up were associated with prodromal depression; less variability of time falling asleep and time waking up were linked with prodromal (hypo)mania.

Conclusion

Using self-assessed sleep changes and especially variability can be potential tools in helping patients identify early warning signs of mood recurrence; however, these analyses were explorative and further investigations are warranted.

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来源期刊
Bipolar Disorders
Bipolar Disorders 医学-精神病学
CiteScore
8.20
自引率
7.40%
发文量
90
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.
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