University of Pittsburgh, PA.
University of Pittsburgh, PA.
J Am Acad Child Adolesc Psychiatry. 2019 Jun;58(6):608-617. doi: 10.1016/j.jaac.2018.09.448. Epub 2019 Mar 6.
Sleep disturbance may be involved in symptom progression across multiple domains of psychopathology and could represent a target for treatment development in youth. Our objective was to identify sleep patterns that longitudinally change in conjunction with psychiatric symptom severity in at-risk youth.
The study included 484 Pittsburgh Bipolar Offspring Study (BIOS) youth with at least 2 sleep assessments occurring between 10 and 18 years of age: 267 offspring of parents with bipolar I or II disorder and 217 community comparison offspring. Assessments occurred approximately every 2 years (mean number of assessments, 2.8 ± 0.8; mean follow-up duration, 3.8 ± 1.6 years). Offspring had a range of psychiatric diagnoses at baseline. Multivariate lasso regression was implemented to select offspring-reported sleep patterns associated with changes in five psychiatric symptom measures from baseline through last follow-up (mania, depression, mood lability, anxiety, inattention/externalizing). Analyses accounted for parent psychiatric diagnoses and offspring demographics, psychiatric diagnoses, and medications.
Follow-up duration, baseline socioeconomic status, parental history of bipolar disorder, offspring attention-deficit/hyperactivity disorder, and disruptive behavior disorder, and five sleep patterns were identified as predictors of change in all five psychiatric symptom measures. Decreasing sleep duration, later sleep timing preference, longer sleep latency, increasing nighttime awakenings, and greater sleepiness over follow-up were associated with increasing severity the five psychiatric symptom outcomes over follow-up. These 10 predictors explained 16% of the variance in longitudinal psychiatric symptom change, 33% of which was accounted for by sleep predictors.
A constellation of sleep features were associated with psychiatric symptom changes in youth, and may represent viable targets for future interventions.
睡眠障碍可能与多种精神病理学领域的症状进展有关，并且可能代表青少年治疗开发的目标。我们的目的是确定与高危青年精神症状严重程度纵向变化相关的睡眠模式。
该研究包括 484 名匹兹堡双相障碍后代研究（BIOS）青年，他们在 10 至 18 岁之间至少进行了 2 次睡眠评估：267 名父母患有双相 I 型或 II 型障碍的后代和 217 名社区比较后代。评估大约每 2 年进行一次（平均评估次数为 2.8±0.8；平均随访时间为 3.8±1.6 年）。后代在基线时有一系列精神科诊断。实施多变量套索回归以选择与从基线到最后一次随访的五个精神症状测量值变化相关的后代报告的睡眠模式（躁狂症、抑郁症、情绪波动、焦虑症、注意力不集中/外化）。分析考虑了父母的精神科诊断以及后代的人口统计学、精神科诊断和药物治疗。
随访时间、基线社会经济地位、父母的双相障碍史、后代的注意力缺陷/多动障碍和破坏性行为障碍，以及五个睡眠模式被确定为所有五个精神症状测量值变化的预测因素。随访期间睡眠持续时间缩短、睡眠时间偏好延迟、睡眠潜伏期延长、夜间觉醒次数增加以及嗜睡程度增加与随访期间五个精神症状结局严重程度增加相关。这 10 个预测因素解释了纵向精神症状变化的 16%，其中 33%由睡眠预测因素解释。
一系列睡眠特征与青少年精神症状变化相关，可能代表未来干预的可行目标。
