Department of Psychiatry, University of Michigan, Ann Arbor, Michigan; Department of Psychology, University of Michigan, Ann Arbor, Michigan.
Department of Psychology, University of Michigan, Ann Arbor, Michigan.
J Affect Disord. 2021 Oct 1;293:133-140. doi: 10.1016/j.jad.2021.06.022. Epub 2021 Jun 18.
Individuals with bipolar I disorder (BD-I) experience both poor sleep and neuropsychological dysfunction relative to non-psychiatric populations, which limits functional recovery. Poor sleep adversely affects learning, memory, and executive functioning in healthy individuals; however, little is known about the role of poor sleep in neuropsychological functioning in BD-I. We tested whether sleep disturbance was greater in BD-I than healthy control participants (HC), and compared the effect of sleep quality on learning, memory, and executive functioning between BD-I and HC.
Participants with BD-I (N=250) and HC (N=206) completed the Pittsburgh Sleep Quality Index, neuropsychological testing, and clinician-administered mood measures as part of a naturalistic study of bipolar disorder. We examined effects of both diagnosis and sleep quality on neuropsychological functioning.
Relative to HC, BD-I showed poorer sleep quality and neuropsychological functioning in verbal learning, verbal and visual memory, processing speed, psychomotor speed, inhibitory control, and selective attention (7/9 domains). Poor sleep quality was associated with poorer verbal learning, verbal fluency, processing speed, and interference control (4/9). Effects of poor sleep on neuropsychological functioning did not differ between BD-I and HC.
The assessment of sleep quality using a self-report measure and the effects of medications/sleeping aids (given the naturalistic study design) should be considered when interpreting results.
Those with BD-I experiencing poor sleep may also be more vulnerable to verbal learning and executive functioning impairments. The findings of poor sleep in relation to poorer neuropsychological functioning have implications for assessment and treatment of sleep disturbance in BD-I.
与非精神病患者群体相比，双相情感障碍 I 型（BD-I）个体的睡眠质量较差，神经认知功能也较差，这限制了他们的功能恢复。较差的睡眠质量会对健康个体的学习、记忆和执行功能产生不利影响；然而，关于睡眠质量差在 BD-I 中的神经认知功能中的作用知之甚少。我们检验了 BD-I 患者的睡眠障碍是否比健康对照组（HC）更严重，并比较了 BD-I 和 HC 之间睡眠质量对学习、记忆和执行功能的影响。
250 名 BD-I 患者和 206 名 HC 参与者完成了匹兹堡睡眠质量指数、神经心理学测试和临床医生管理的情绪测量，作为双相情感障碍自然研究的一部分。我们检验了诊断和睡眠质量对神经认知功能的影响。
与 HC 相比，BD-I 患者的睡眠质量和神经认知功能（9 个领域中的 7 个）更差，包括言语学习、言语和视觉记忆、加工速度、运动速度、抑制控制和选择性注意。较差的睡眠质量与言语学习、言语流畅性、加工速度和干扰控制（9 个领域中的 4 个）较差相关。BD-I 和 HC 之间，睡眠质量差对神经认知功能的影响没有差异。
考虑到自然研究设计，使用自我报告量表评估睡眠质量和药物/助眠剂的影响时，应解释结果。
BD-I 中经历较差睡眠的个体可能更容易出现言语学习和执行功能障碍。睡眠质量与较差的神经认知功能之间的关联对 BD-I 中睡眠障碍的评估和治疗具有启示意义。
