Brill Sharon, Penagaluri Praveen, Roberts R Jeannie, Gao YongLin, El-Mallakh Rif S
Mood Disorders Research Program, Department of Psychiatry and Behavioral Science, University of Louisville School of Medicine, Louisville, KY, USA.
Ann Clin Psychiatry. 2011 May;23(2):113-6.
Sleep disturbance has been implicated in both prodromal and syndromal phases of bipolar illness.
Charts of bipolar disorder (BD) patients who had been euthymic for at least 2 months were reviewed for mood symptoms, Clinical Global Impression scores, Global Assessment of Functioning scores, and sleep.
Among 116 patients, 10 never achieved a euthymic interval of 2 months' duration. Among the remaining 106 euthymic patients, 59 (55.6%) had BD I, 23 (21.7%) had BD II, and 24 (22.8%) had BD not otherwise specified (NOS). The mean age was 43.3±SD 14.6, and 35% were male. A total of 25 patients (23.6%) had a clinically significant ongoing sleep disturbance (27.1% of those with BD I, 21.7% of those with BD II, and 16.6% of those with BD NOS). Of 16 patients for whom a sleep description was available, 25% had difficulty falling asleep, 81.25% had middle insomnia (2 patients experienced both), and none had early morning awakening. Eleven patients (10.4%) received sleep aids, and 33 (31.1%) received sedating antipsychotics (3 patients received both).
Sleeping aids and sedating antipsychotics can potentially disguise an underlying sleep disturbance. Thus, it is possible that study patients taking these medications (n = 58; 54.7%) suffer from a sleep disturbance that is being adequately or inadequately treated.
睡眠障碍与双相情感障碍的前驱期和综合征期均有关联。
对至少2个月处于心境正常期的双相情感障碍（BD）患者的病历进行回顾，评估其情绪症状、临床总体印象评分、功能总体评估评分及睡眠情况。
116例患者中，10例从未达到过2个月的心境正常期。在其余106例心境正常的患者中，59例（55.6%）为双相I型障碍，23例（21.7%）为双相II型障碍，24例（22.8%）为未特定型双相障碍（NOS）。平均年龄为43.3±标准差14.6岁，35%为男性。共有25例患者（23.6%）存在临床上显著的持续性睡眠障碍（双相I型障碍患者中占27.1%，双相II型障碍患者中占21.7%，未特定型双相障碍患者中占16.6%）。在有睡眠描述的16例患者中，25%入睡困难，81.25%存在中程失眠（2例兼有两种情况），无晨醒困难者。11例患者（10.4%）使用了助眠药物，33例患者（31.1%）使用了镇静性抗精神病药物（3例同时使用了两种药物）。
助眠药物和镇静性抗精神病药物可能会掩盖潜在的睡眠障碍。因此，服用这些药物的研究患者（n = 58；54.7%）有可能存在未得到充分治疗或治疗不当的睡眠障碍。
