Abstract
Recent studies have suggested that there are certain pathophysiological relationships between bipolar disorder (BD) and circadian rhythm dysfunction. However, apparently no studies have clarified the prevalence of circadian rhythm sleep-wake disorders (CRSWD) in patients with BD. This study was set out to investigate the prevalence of CRSWD and associated factors in patients with BD. One hundred four euthymic BD outpatients participated in this study. The subjects were asked to answer questionnaires including demographic variables, clinical course of BD, and family history of psychiatric disorders and suicide. Severity of BD was assessed by the Montgomery-Åsberg Depression Rating Scale and Young Mania Rating Scale. CRSWD was diagnosed by clinical interview, together with sleep logs, according to the International Classification of Sleep Disorders, third edition (ICSD-3). Thirty-five subjects (32.4%) met the criteria for CRSWD. The age at the time of investigation and that at the onset of BD were both lower in the CRSWD group than in the non-CRSWD group. The rates of family history of psychiatric disorders and suicide in the CRSWD group were higher than those in the non-CRSWD group. Multiple logistic regression analysis revealed that the presence of CRSWD was significantly associated with younger onset age of BD and family history of suicide. The prevalence of CRSWD could be quite high in BD patients. Younger onset age of BD and family history of suicide were associated with presence of CRSWD in BD patients.
Highlights
The circadian system regulates daily rhythms of physiology and behavior, such as the sleepwake cycle, core body temperature, hormonal secretion, and mood [1]
Six patients met the criteria for non-24-hour sleep-wake rhythm disorder, which is characterized by symptoms of insomnia or excessive sleepiness that occur because the intrinsic circadian pacemaker is not entrained to a 24-hour light/dark cycle [29,30] (Fig 1)
P-value 0.068 0.002 0.150 0.038 sensitivity was 48.6%, specificity was 92.8%, and predictive accuracy was 77.9% in this regression analysis model. This is the first study to investigate the prevalence of circadian rhythm sleep-wake disorders (CRSWD) in bipolar disorder (BD) patients in clinical settings
Summary
The circadian system regulates daily rhythms of physiology and behavior, such as the sleepwake cycle, core body temperature, hormonal secretion, and mood [1]. Takeshi Inoue has received honoraria from GlaxoSmithKline, Pfeizer, Eli Lilly, Mitsubishi Tanabe Pharma, Mochida Pharmaceutical, Otsuka Pharmaceutical, Meiji Seika Pharma, Asahi Kasei Pharma, Shionogi, Dainippon Sumitomo Pharma, Takeda Pharmaceutical, MSD, Eisai and Yoshitomi Pharmaceutical, has received research/grant support from Otsuka Pharmaceutical, Eli Lilly, Eisai, Mitsubishi Tanabe Pharma, Abbvie, Pfeizer, Astellas and Meiji Seika Pharma, and is a member of the advisory boards of GlaxoSmithKline, Pfeizer, Eli Lilly, Mochida Pharmaceutical and Mitsubishi Tanabe Pharma. This does not alter the authors' adherence to PLoS ONE policies on sharing data and materials
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