The relationship between sleep and circadian patterns with risk for suicide in bipolar disorder varies by subtype.

Abstract

Sleep and circadian disturbances play a crucial role in psychiatric disorders, especially mood disorders such as bipolar disorder. This study investigated the predictive value of self-reported sleep and circadian factors for suicide risk in individuals with bipolar type I and bipolar type II disorder. Data were collected from the Heinz C. Prechter Longitudinal Study of Bipolar Disorder. Suicide risk was evaluated using the Columbia Suicide-Severity Rating Scale, while the sleep and circadian factors were extracted from the Pittsburgh Sleep Quality Index, Hamilton Depression Rating Scale, and Munich Chronotype Questionnaire. A stepwise selection procedure identified significant predictors for each group. Results showed that suicide risk in individuals with bipolar disorder type I was associated with insomnia, whereas risk in bipolar disorder type II was associated with evening chronotype. These findings indicate that specific sleep and circadian disturbance variables confer unique risk for suicide in the subtypes of bipolar disorder. This highlights the importance of conducting a thorough sleep and circadian assessment in clinical practice and emphasizes the need for clinical trials investigating the impact of sleep and circadian interventions on mitigating suicide risk in individuals with bipolar disorder.