Department of Psychiatry, Okehazama Hospital, Aichi, Japan; Department of Psychiatry, Fujita Health University School of Medicine, Aichi, Japan.
Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan.
J Affect Disord. 2023 Feb 15;323:762-769. doi: 10.1016/j.jad.2022.12.034. Epub 2022 Dec 17.
Circadian activity rhythm disruption is a core feature in bipolar disorder. We investigated whether light exposure in daily life is associated with circadian activity rhythms in patients with bipolar disorder.
In a cross-sectional study, we enrolled 194 outpatients with bipolar disorder who were participants of the Association between Pathology of Bipolar Disorder and Light Exposure in Daily Life (APPLE) cohort study. The participants' physical activity and daytime illuminance were measured using an actigraph over 7 consecutive days. Nighttime illuminance in the bedroom was measured using a portable photometer. Circadian activity rhythm parameters were calculated using cosinor analysis and a nonparametric circadian rhythm analysis.
The median daytime illuminance and nighttime illuminance were 224.5 lx (interquartile range, 154.5-307.5 lx) and 2.3 lx (0.3-9.4 lx), respectively. Multivariable linear regression analysis, adjusted for potential confounding factors, showed that higher daytime illuminance was significantly associated with higher amplitude and most active continuous 10-hour period, advanced acrophase, higher interdaily stability, and lower intradaily variability. Higher nighttime illuminance was significantly associated with lower relative amplitude, delayed onset of the least active continuous 5-hour period, and higher intradaily variability.
As this was a cross-sectional study, the results do not necessarily imply that light exposure alters circadian activity rhythms.
Daytime light exposure was associated with a positive effect and nighttime light exposure with a negative effect on circadian activity rhythms in bipolar disorder.
昼夜活动节律紊乱是双相障碍的核心特征。我们研究了日常生活中的光照暴露是否与双相障碍患者的昼夜活动节律有关。
在一项横断面研究中，我们招募了 194 名参加双相障碍病理学与日常生活中的光照暴露关联（APPLE）队列研究的门诊患者。使用活动记录仪连续 7 天测量参与者的身体活动和日间照度。使用便携式光度计测量卧室的夜间照度。使用余弦分析和非参数昼夜节律分析计算昼夜活动节律参数。
日间照度的中位数为 224.5 lx（四分位间距，154.5-307.5 lx），夜间照度为 2.3 lx（0.3-9.4 lx）。多变量线性回归分析，调整了潜在的混杂因素，显示较高的日间照度与较高的振幅和最活跃的连续 10 小时期、提前的高峰相位、较高的日间稳定性和较低的日内变异性有关。较高的夜间照度与较低的相对振幅、最不活跃的连续 5 小时期的延迟开始以及较高的日内变异性有关。
由于这是一项横断面研究，结果不一定表明光照暴露会改变昼夜活动节律。
日间光照暴露与双相障碍昼夜活动节律呈正相关，夜间光照暴露与昼夜活动节律呈负相关。
