Sleep and physical activity in patients with newly diagnosed bipolar disorder in remission, their first-degree unaffected relatives and healthy controls

Nikolaj Folke La Cour Karottki,Lars Vedel Kessing,Sharleny Stanislaus,Hanne Lie Kjærstad,Kimie Stefanie Ormstrup Sletved,Maj Vinberg,Sigurd Melbye,Klara Coello

doi:10.1186/s40345-020-00181-6

Abstract

BackgroundSleep disturbances are a central feature in bipolar disorder (BD) that often persist in remission and seem to be present also in unaffected first-degree relatives (UR) of patients with BD, presenting a possible risk factor for later onset of BD. However, it is unknown if these disturbances are associated with unhealthy life-style as reflected in low levels of physical activity. We investigated sleep disturbances and physical activity levels in patients with newly diagnosed BD in full or partial remission, their UR and healthy controls (HC).MethodsSleep patterns and physical activity were compared in 227 patients with newly diagnosed BD, 76 UR and 148 HC. The Pittsburgh Sleep Quality Index (PSQI) and the International Physical Activity Questionnaire (IPAQ) were used to assess sleep disturbances and physical activity, respectively.ResultsIn sex- and age-adjusted analyses, patients with BD exhibited more sleep disturbances and lower physical activity compared with UR and HC, respectively. Unaffected relatives reported significantly longer sleep latency and a non-significant trend towards more overall sleep disturbances compared with HC.ConclusionsSleep disturbances and less physical activity are present in patients with newly diagnosed BD in partial or full remission. Individuals at familiar risk of BD reported longer sleep latency and similar physical activity compared with HC. Further prospective studies are needed to clarify whether these discrete sleep disturbances act as risk factor for later onset of BD and whether increased physical activity in high-risk individuals may act as a protective factor against development of psychiatric illness.

Highlights

Sleep disturbances are a central feature in bipolar disorder (BD) that often persist in remission and seem to be present in unaffected first-degree relatives (UR) of patients with BD, presenting a possible risk factor for later onset of BD
Demographic and clinical characteristics We included 451 participants, 227 patients newly diagnosed with BD in full or partial remission, 78 UR and 148 healthy controls (HC)
After adjusting for Hamilton Depression Scale-17 items (HAMD-17) score, we found no statistically significant differences in International Physical Activity Questionnaire (IPAQ) score between the groups (BD vs. HC: p = 0.304, BD vs. UR: p = 0.155, UR vs. HC: p = 0.603) while the differences remained significant when adjusting for Young Mania Rating Scale (YMRS) score (BD vs. HC: p = 0.008, BD vs. UR: p = 0.012, UR vs. HC p = 0.689)

Summary

Introduction

Sleep disturbances are a central feature in bipolar disorder (BD) that often persist in remission and seem to be present in unaffected first-degree relatives (UR) of patients with BD, presenting a possible risk factor for later onset of BD. It is unknown if these disturbances are associated with unhealthy life-style as reflected in low levels of physical activity. Bipolar disorder (BD) is a recurrent mood disorder with episodes of depression and mania It is often associated with functional disability, decreased quality of life and reduced life expectancy (Rosa et al 2014; Kessing and Andersen 2017). Early treatment seems to hinder a more severe progression of the disorder (Bender and Alloy 2011; Shapero et al 2017; Kessing et al 2014) and it is crucial to discover robust risk factors and valid biomarkers

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