Ng Tommy H, Chung Ka-Fai, Ng Ting-Kin, Lee Chit-Tat, Chan Man-Sum
Department of Psychology, Temple University, Philadelphia, PA, United States.
Department of Psychiatry, University of Hong Kong, Hong Kong, SAR, China.
Compr Psychiatry. 2016 Aug;69:155-62. doi: 10.1016/j.comppsych.2016.05.016. Epub 2016 May 30.
Sleep-wake disturbances, such as sleep irregularity, are common in bipolar disorder. Early studies suggest that sleep irregularity is associated with mood symptoms in bipolar disorder, but little research has been conducted to identify other correlates of sleep irregularity. We investigated the relationship between sleep irregularity and sleep quality, social rhythms, eveningness, sleep-related cognitions and behaviors, and past and future mood episodes in 84 patients with inter-episode bipolar I or II disorder.
This is a retrospective and prospective, naturalistic follow-up study. The Expanded Consensus Sleep Diary, Pittsburgh Sleep Quality Index (PSQI), Social Rhythm Metric (SRM-II-5), Composite Scale of Morningness (CSM), Dysfunctional Beliefs and Attitudes About Sleep Scale (DBAS-16), and Sleep Hygiene Practice Scale (SHPS) were administered. The Square Successive Difference (SSD), derived from a week-long sleep diary, was used as an index of sleep irregularity. Multilevel modeling analysis, which adjusts for biases in parameter estimates, was used to minimize the impact of missing data. Bonferroni correction was performed to account for multiple testing.
Higher SSD scores of sleep diary variables were significantly associated with higher PSQI, SRM-II-5, DBAS-16, and SHPS scores. Irregularity in total sleep time was related to more depressive episodes in the past 5years (p=.002), while irregularity in wake after sleep onset predicted the onset of depressive episodes over the next 2years (p=.002).
Sleep irregularity was associated with poor sleep quality, irregular social rhythms, dysfunctional sleep-related cognitions and behaviors, and greater number of depressive episodes in bipolar disorder.
睡眠-觉醒障碍，如睡眠不规律，在双相情感障碍中很常见。早期研究表明，睡眠不规律与双相情感障碍的情绪症状有关，但很少有研究去确定睡眠不规律的其他相关因素。我们调查了84例发作间期双相I型或II型障碍患者的睡眠不规律与睡眠质量、社会节律、晚睡倾向、与睡眠相关的认知和行为，以及过去和未来情绪发作之间的关系。
这是一项回顾性和前瞻性的自然主义随访研究。采用了扩展的共识睡眠日记、匹兹堡睡眠质量指数（PSQI）、社会节律量表（SRM-II-5）、晨型综合量表（CSM）、睡眠功能失调信念与态度量表（DBAS-16）和睡眠卫生实践量表（SHPS）。从为期一周的睡眠日记中得出的平方连续差（SSD）被用作睡眠不规律的指标。采用多水平建模分析来调整参数估计中的偏差，以尽量减少缺失数据的影响。进行了Bonferroni校正以考虑多重检验。
睡眠日记变量的较高SSD分数与较高的PSQI、SRM-II-5、DBAS-16和SHPS分数显著相关。总睡眠时间的不规律与过去5年中更多的抑郁发作有关（p = 0.002），而睡眠开始后觉醒的不规律则预测了未来2年抑郁发作的发生（p = 0.002）。
睡眠不规律与双相情感障碍中睡眠质量差、社会节律不规律、与睡眠相关的认知和行为功能失调以及更多的抑郁发作有关。
