Gross Grégory, Maruani Julia, Vorspan Florence, Benard Victoire, Benizri Chloé, Brochard Héléna, Geoffroy Pierre-Alexis, Kahn Jean-Pierre, Yeim Sunthavy, Leboyer Marion, Bellivier Frank, Etain Bruno
INSERM U1144, Optimisation Thérapeutique en Neuropsychopharmacologie , Paris, France.
Pôle de Psychiatrie et Psychologie Clinique, Centre Psychothérapique de Nancy , Laxou, France.
Chronobiol Int. 2020 May;37(5):712-722. doi: 10.1080/07420528.2020.1725542. Epub 2020 Feb 12.
Individuals with bipolar disorder (BD) have higher than average rates of coffee, tobacco and alcohol use. These substances may have deleterious effects on sleep quality and quantity, which may destabilize sleep/wake cycles and negatively impact the clinical course and prognosis of BD. The use of these substances may also be perceived as a self-medication attempt, for example, to induce sleep or to increase vigilance during the day. The objective of the current study was to investigate associations between the self-reported daily use of coffee, tobacco, and alcohol, and objective measures of sleep and activity patterns in adult individuals with BD. A sample of 147 euthymic individuals with BD were assessed for daily coffee, tobacco and alcohol consumption and 21 days of actigraphy monitoring. Actigraphic measures of sleep quantity and daytime activity were compared between groups classified as coffee+/coffee-, tobacco+/tobacco- and alcohol+/alcohol-, defined according to their current daily use. Then, we examined potential correlations between sleep/wake cycle parameters and the amount of daily consumption of each substance. Multivariable analyses identified associations between the use of coffee, tobacco, and alcohol and several sleep and activity parameters, such as between coffee, alcohol, and the relative amplitude of activity (respectively, = .003 and = .005), between alcohol and M10 onset (onset time of the 10 most active hours during the 24-h cycle) ( = .003), and between coffee and sleep duration ( = .047). This study supports the hypothesis that there is a relationship, whose direction would be bidirectional, between the daily use of these substances and the sleep/wake cycle in euthymic individuals with BD. These preliminary results require replications in other retrospective and prospective samples. They may have a clinical impact on psycho-education strategies to be proposed to individuals with BD.
双相情感障碍（BD）患者的咖啡、烟草和酒精使用率高于平均水平。这些物质可能会对睡眠质量和时长产生有害影响，进而破坏睡眠/觉醒周期，并对双相情感障碍的临床病程和预后产生负面影响。使用这些物质也可能被视为一种自我治疗的尝试，例如，用于诱导睡眠或提高白天的警觉性。本研究的目的是调查成年双相情感障碍患者自我报告的咖啡、烟草和酒精每日使用情况与睡眠及活动模式的客观测量指标之间的关联。对147名处于情感平稳期的双相情感障碍患者进行了每日咖啡、烟草和酒精摄入量评估以及21天的活动记录仪监测。根据当前每日使用情况将研究对象分为咖啡使用组/非使用组、烟草使用组/非使用组和酒精使用组/非使用组，比较各组间睡眠时长和白天活动的活动记录仪测量指标。然后，我们研究了睡眠/觉醒周期参数与每种物质每日摄入量之间的潜在相关性。多变量分析确定了咖啡、烟草和酒精的使用与若干睡眠和活动参数之间的关联，例如咖啡、酒精与活动相对幅度之间的关联（分别为p = .003和p = .005），酒精与M10开始时间（24小时周期内最活跃的10个小时的开始时间）之间的关联（p = .003），以及咖啡与睡眠时间之间的关联（p = .047）。本研究支持这样一种假设，即在处于情感平稳期的双相情感障碍患者中，这些物质的每日使用与睡眠/觉醒周期之间存在一种双向关系。这些初步结果需要在其他回顾性和前瞻性样本中进行重复验证。它们可能会对拟向双相情感障碍患者提出的心理教育策略产生临床影响。
