Department of Psychiatry, Penn State University, Hershey, PA, USA; Sleep Research and Treatment Center, Penn State Milton S Hershey Medical Center, Hershey, PA, USA.
Department of Psychiatry, Penn State University, Hershey, PA, USA.
J Affect Disord. 2018 Mar 15;229:247-253. doi: 10.1016/j.jad.2017.12.100. Epub 2018 Jan 3.
Bipolar disorder (BD) is associated with sleep misperception. The objective of this study was to investigate the correlation between subjective and objective measures of sleep in persons with symptomatic bipolar disorder (BDS) compared to healthy controls (HC).
We studied 24 BDS and 30 HC subjects similar in age, race and sex. Subjective sleep was measured with Pittsburgh Sleep Quality Index (PSQI) and objective sleep with 7-days of actigraphy. Absolute discrepancy variables were calculated by subtracting objective sleep latency (SL) and total sleep time (TST) on actigraphy from their respective subjective estimates from PSQI. Mood symptoms were measured with Young Mania Rating Scale and Hamilton Depression Rating Scale.
In the BDS group, subjective TST did not significantly correlate with objective TST, while it correlated in the HC group. The BDS group had significantly higher absolute discrepancy between subjective and objective SL and TST compared to the HC group. Multivariable regression analysis showed that severity of depression was associated with greater absolute discrepancy between subjective and objective TST within the BDS group.
Subjects are from a tertiary care center and were on medications for treatment of BD symptoms.
There is low correlation between subjective and objective TST in BDS subjects and more severe depressive symptoms are associated with greater absolute discrepancy in TST. Objective rather than subjective measures of sleep, such as actigraphy, may be needed to evaluate sleep in BD subjects. Cognitive-behavioral interventions to address sleep misperception and associated depressed mood may be indicated in BD.
双相障碍（BD）与睡眠感知错误有关。本研究的目的是调查与健康对照组（HC）相比，有症状的双相障碍（BDS）患者的主观和客观睡眠测量之间的相关性。
我们研究了 24 名 BDS 和 30 名 HC 受试者，他们在年龄、种族和性别方面相似。使用匹兹堡睡眠质量指数（PSQI）评估主观睡眠，使用 7 天的活动记录仪评估客观睡眠。通过从 PSQI 中主观估计的客观睡眠潜伏期（SL）和总睡眠时间（TST）中减去客观 SL 和 TST 的绝对值差异变量。使用 Young 躁狂评定量表和汉密尔顿抑郁评定量表评估情绪症状。
在 BDS 组中，主观 TST 与客观 TST 无显著相关性，而在 HC 组中则有相关性。BDS 组的主观和客观 SL 和 TST 之间的绝对差异明显高于 HC 组。多变量回归分析显示，BDS 组中抑郁严重程度与主观和客观 TST 之间的绝对差异较大相关。
受试者来自三级护理中心，正在服用治疗 BD 症状的药物。
BDS 受试者的主观和客观 TST 之间相关性较低，抑郁症状越严重，TST 的绝对差异越大。可能需要使用活动记录仪等客观而非主观的睡眠测量来评估 BD 患者的睡眠。可能需要针对睡眠感知错误和相关抑郁情绪的认知行为干预措施。
