Boudebesse C, Geoffroy P-A, Henry C, Germain A, Scott J, Lajnef M, Leboyer M, Bellivier F, Etain B
Inserm, U955, Créteil, France; AP-HP, Hôpital H.-Mondor-A.-Chenevier, Pôle de Psychiatrie, DHU PePSY, Créteil, France; Fondation Fondamental, Créteil, France.
Inserm, U955, Créteil, France; Fondation Fondamental, Créteil, France; Pôle de Psychiatrie, Université Lille Nord de France, CHRU de Lille, Lille, France.
Eur Psychiatry. 2015 Jan;30(1):89-93. doi: 10.1016/j.eurpsy.2014.04.006. Epub 2014 Jun 5.
Obesity and excess bodyweight are highly prevalent in individuals with bipolar disorders (BD) and are associated with adverse consequences. Multiple factors may explain increased bodyweight in BD including side effects of psychotropic medications, and reduced physical activity. Research in the general population demonstrates that sleep disturbances may also contribute to metabolic burden. We present a cross-sectional study of the associations between body mass index (BMI) and sleep parameters in patients with BD as compared with healthy controls (HC).
Twenty-six French outpatients with remitted BD and 29 HC with a similar BMI completed a 21-day study of sleep parameters using objective (actigraphy) and subjective (PSQI: Pittsburgh Sleep Quality Index) assessments.
In BD cases, but not in HC, higher BMI was significantly correlated with lower sleep efficiency (P=0.009) and with several other sleep parameters: shorter total sleep time (P=0.01), longer sleep onset latency (P=0.05), higher fragmentation index (P=0.008), higher inter-day variability (P=0.05) and higher PSQI total score (P=0.004).
The findings suggest a link between a high BMI and several sleep disturbances in BD, including lower sleep efficiency. Physiological mechanisms in BD cases may include an exaggeration of phenomena observed in non-clinical populations. However, larger scale studies are required to clarify the links between metabolic and sleep-wake cycle disturbances in BD.
肥胖和超重在双相情感障碍（BD）患者中极为普遍，且与不良后果相关。多种因素可解释BD患者体重增加的现象，包括精神药物的副作用以及身体活动减少。普通人群的研究表明，睡眠障碍也可能导致代谢负担加重。我们开展了一项横断面研究，比较BD患者与健康对照者（HC）的体重指数（BMI）与睡眠参数之间的关联。
26名病情缓解的法国BD门诊患者和29名BMI相似的HC完成了一项为期21天的睡眠参数研究，采用客观（活动记录仪）和主观（匹兹堡睡眠质量指数PSQI）评估方法。
在BD患者中，而非HC中，较高的BMI与较低的睡眠效率显著相关（P = 0.009），并与其他几个睡眠参数相关：总睡眠时间较短（P = 0.01）、入睡潜伏期较长（P = 0.05）、碎片化指数较高（P = 0.008）、日间变异性较高（P = 0.05）以及PSQI总分较高（P = 0.004）。
研究结果表明，BD患者中高BMI与多种睡眠障碍之间存在关联，包括睡眠效率较低。BD患者的生理机制可能包括非临床人群中观察到的现象的夸大。然而，需要更大规模的研究来阐明BD患者代谢与睡眠-觉醒周期障碍之间的联系。
