Gold Alexandra K, Sylvia Louisa G
Department of Psychiatry, Massachusetts General Hospital.
Department of Psychiatry, Massachusetts General Hospital; Harvard Medical School, Boston, MA, USA.
Nat Sci Sleep. 2016 Jun 29;8:207-14. doi: 10.2147/NSS.S85754. eCollection 2016.
Bipolar disorder is a serious mental illness characterized by alternating periods of elevated and depressed mood. Sleep disturbances in bipolar disorder are present during all stages of the condition and exert a negative impact on overall course, quality of life, and treatment outcomes. We examine the partnership between circadian system (process C) functioning and sleep-wake homeostasis (process S) on optimal sleep functioning and explore the role of disruptions in both systems on sleep disturbances in bipolar disorder. A convergence of evidence suggests that sleep problems in bipolar disorder result from dysregulation across both process C and process S systems. Biomarkers of depressive episodes include heightened fragmentation of rapid eye movement (REM) sleep, reduced REM latency, increased REM density, and a greater percentage of awakenings, while biomarkers of manic episodes include reduced REM latency, greater percentage of stage I sleep, increased REM density, discontinuous sleep patterns, shortened total sleep time, and a greater time awake in bed. These findings highlight the importance of targeting novel treatments for sleep disturbance in bipolar disorder.
双相情感障碍是一种严重的精神疾病，其特征是情绪高涨和低落交替出现。双相情感障碍患者在疾病的各个阶段都会出现睡眠障碍，对疾病的整体病程、生活质量和治疗效果产生负面影响。我们研究昼夜节律系统（C过程）功能与睡眠-觉醒稳态（S过程）之间的协同作用对最佳睡眠功能的影响，并探讨这两个系统的紊乱在双相情感障碍睡眠障碍中的作用。越来越多的证据表明，双相情感障碍的睡眠问题是由C过程和S过程系统的失调导致的。抑郁发作的生物标志物包括快速眼动（REM）睡眠的碎片化加剧、REM潜伏期缩短、REM密度增加以及觉醒百分比增加，而躁狂发作的生物标志物包括REM潜伏期缩短、I期睡眠百分比增加、REM密度增加、睡眠模式不连续、总睡眠时间缩短以及卧床清醒时间增加。这些发现凸显了针对双相情感障碍睡眠障碍开发新治疗方法的重要性。
